Provider Demographics
NPI:1164773925
Name:MARR, BRIGITTE CHRISTINE (OTR/L)
Entity Type:Individual
Prefix:
First Name:BRIGITTE
Middle Name:CHRISTINE
Last Name:MARR
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:44118 234TH PL SE
Mailing Address - Street 2:
Mailing Address - City:ENUMCLAW
Mailing Address - State:WA
Mailing Address - Zip Code:98022-8407
Mailing Address - Country:US
Mailing Address - Phone:360-367-1122
Mailing Address - Fax:
Practice Address - Street 1:3240 MCDOUGALL AVE
Practice Address - Street 2:
Practice Address - City:ENUMCLAW
Practice Address - State:WA
Practice Address - Zip Code:98022-9430
Practice Address - Country:US
Practice Address - Phone:360-802-7370
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-09-19
Last Update Date:2012-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAOT 00001318225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist