Provider Demographics
NPI:1093032385
Name:BRAZIL, AMY L (LMP)
Entity Type:Individual
Prefix:
First Name:AMY
Middle Name:L
Last Name:BRAZIL
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 1:7409 GREENWOOD AVE N
Mailing Address - Street 2:SUITE E
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98103-5063
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:7409 GREENWOOD AVE N
Practice Address - Street 2:SUITE E
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98103-5063
Practice Address - Country:US
Practice Address - Phone:206-782-4157
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-04-26
Last Update Date:2010-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist