Provider Demographics
NPI:1013543206
Name:SNEED, BRENNA JANE (MBA, LAT, ATC)
Entity Type:Individual
Prefix:
First Name:BRENNA
Middle Name:JANE
Last Name:SNEED
Suffix:
Gender:F
Credentials:MBA, LAT, ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6401 20TH AVE NW APT 6
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98107-2388
Mailing Address - Country:US
Mailing Address - Phone:715-209-1503
Mailing Address - Fax:
Practice Address - Street 1:6001 36TH AVE W
Practice Address - Street 2:
Practice Address - City:EVERETT
Practice Address - State:WA
Practice Address - Zip Code:98203-1264
Practice Address - Country:US
Practice Address - Phone:425-266-6326
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-03-19
Last Update Date:2020-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAA1609316442255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer