Provider Demographics
NPI:1184837858
Name:DUZAN, BRENDA JOYCE (LAC)
Entity Type:Individual
Prefix:MISS
First Name:BRENDA
Middle Name:JOYCE
Last Name:DUZAN
Suffix:
Gender:F
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13210 MERIDIAN E. #C-102
Mailing Address - Street 2:PMB 218
Mailing Address - City:PUYALLUP
Mailing Address - State:WA
Mailing Address - Zip Code:98373
Mailing Address - Country:US
Mailing Address - Phone:253-576-8278
Mailing Address - Fax:
Practice Address - Street 1:5310 138TH ST. E.
Practice Address - Street 2:
Practice Address - City:TACOMA
Practice Address - State:WA
Practice Address - Zip Code:98446
Practice Address - Country:US
Practice Address - Phone:253-576-8278
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAAC00000485171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist