Provider Demographics
NPI:1114346699
Name:DAVID, BRENNA MURRAY (DPT,OCS)
Entity Type:Individual
Prefix:
First Name:BRENNA
Middle Name:MURRAY
Last Name:DAVID
Suffix:
Gender:F
Credentials:DPT,OCS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:800 NE 67TH ST APT 304
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98115-5761
Mailing Address - Country:US
Mailing Address - Phone:253-307-9237
Mailing Address - Fax:
Practice Address - Street 1:2901 3RD AVE
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98121-1042
Practice Address - Country:US
Practice Address - Phone:206-686-4073
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-04-10
Last Update Date:2019-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPT 60436217225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist