Provider Demographics
NPI:1053760090
Name:AUSTIN, BRITTANY MARIE (LMP)
Entity type:Individual
Prefix:MISS
First Name:BRITTANY
Middle Name:MARIE
Last Name:AUSTIN
Suffix:
Gender:F
Credentials:LMP
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Mailing Address - Street 1:26837 MAPLE VALLEY BLACK DIAMOND RD SE
Mailing Address - Street 2:SUITE 200
Mailing Address - City:MAPLE VALLEY
Mailing Address - State:WA
Mailing Address - Zip Code:98038-9917
Mailing Address - Country:US
Mailing Address - Phone:253-631-1933
Mailing Address - Fax:253-631-2094
Practice Address - Street 1:2930 S MERIDIAN
Practice Address - Street 2:SUITE 120
Practice Address - City:PUYALLUP
Practice Address - State:WA
Practice Address - Zip Code:98373-1654
Practice Address - Country:US
Practice Address - Phone:253-445-2733
Practice Address - Fax:253-445-2399
Is Sole Proprietor?:No
Enumeration Date:2016-06-09
Last Update Date:2016-06-09
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
WAMA 60475804225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist