Provider Demographics
NPI:1124394333
Name:FRANK, BRANDY C (LMP)
Entity Type:Individual
Prefix:
First Name:BRANDY
Middle Name:C
Last Name:FRANK
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 1:115-3/4 W MAIN STREET
Mailing Address - Street 2:#213
Mailing Address - City:MONROE
Mailing Address - State:WA
Mailing Address - Zip Code:98272
Mailing Address - Country:US
Mailing Address - Phone:206-619-8061
Mailing Address - Fax:
Practice Address - Street 1:115 3/4 W MAIN ST
Practice Address - Street 2:#213
Practice Address - City:MONROE
Practice Address - State:WA
Practice Address - Zip Code:98272-1831
Practice Address - Country:US
Practice Address - Phone:206-619-8061
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-04-02
Last Update Date:2012-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA60270899225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist