Provider Demographics
NPI:1073656393
Name:FOSTER-RICHARDSON, BRITTANY NA'SHELL (LMP)
Entity Type:Individual
Prefix:MISS
First Name:BRITTANY
Middle Name:NA'SHELL
Last Name:FOSTER-RICHARDSON
Suffix:
Gender:F
Credentials:LMP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:118 SHANTEL ST
Mailing Address - Street 2:
Mailing Address - City:MOUNT VERNON
Mailing Address - State:WA
Mailing Address - Zip Code:98274-3011
Mailing Address - Country:US
Mailing Address - Phone:425-737-3485
Mailing Address - Fax:
Practice Address - Street 1:1020 N CENTER PKWY
Practice Address - Street 2:E
Practice Address - City:KENNEWICK
Practice Address - State:WA
Practice Address - Zip Code:99336-7161
Practice Address - Country:US
Practice Address - Phone:509-735-1109
Practice Address - Fax:509-735-1767
Is Sole Proprietor?:No
Enumeration Date:2007-02-15
Last Update Date:2009-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA00023215225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist