Provider Demographics
NPI:1265855845
Name:ZEIS, BREANNA (LMT)
Entity Type:Individual
Prefix:
First Name:BREANNA
Middle Name:
Last Name:ZEIS
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:624 W HASTINGS RD STE 14
Mailing Address - Street 2:
Mailing Address - City:SPOKANE
Mailing Address - State:WA
Mailing Address - Zip Code:99218-2877
Mailing Address - Country:US
Mailing Address - Phone:509-954-5018
Mailing Address - Fax:509-241-0815
Practice Address - Street 1:624 W. HASTINGS
Practice Address - Street 2:SUITE 16
Practice Address - City:SPOKANE
Practice Address - State:WA
Practice Address - Zip Code:99218
Practice Address - Country:US
Practice Address - Phone:509-954-5018
Practice Address - Fax:509-241-0815
Is Sole Proprietor?:No
Enumeration Date:2014-02-02
Last Update Date:2019-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA 60354048225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist