Provider Demographics
NPI:1285846964
Name:BRADY, CAROLINE (LMP, RDH)
Entity Type:Individual
Prefix:MRS
First Name:CAROLINE
Middle Name:
Last Name:BRADY
Suffix:
Gender:F
Credentials:LMP, RDH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3036 38TH AVE SW
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98126
Mailing Address - Country:US
Mailing Address - Phone:206-618-3423
Mailing Address - Fax:
Practice Address - Street 1:6407 FAUNTLEROY WAY SW
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98136
Practice Address - Country:US
Practice Address - Phone:206-618-3423
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA00013655172M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172M00000XOther Service ProvidersMechanotherapist