Provider Demographics
NPI:1336473651
Name:VERNA, BRIDGETTE (LMP)
Entity Type:Individual
Prefix:
First Name:BRIDGETTE
Middle Name:
Last Name:VERNA
Suffix:
Gender:F
Credentials:LMP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Mailing Address - Street 1:7323 PIONEER HWY
Mailing Address - Street 2:
Mailing Address - City:STANWOOD
Mailing Address - State:WA
Mailing Address - Zip Code:98292-9397
Mailing Address - Country:US
Mailing Address - Phone:425-231-1706
Mailing Address - Fax:360-629-6042
Practice Address - Street 1:9522 271ST ST NW
Practice Address - Street 2:
Practice Address - City:STANWOOD
Practice Address - State:WA
Practice Address - Zip Code:98292-8095
Practice Address - Country:US
Practice Address - Phone:360-629-0800
Practice Address - Fax:360-629-6042
Is Sole Proprietor?:Yes
Enumeration Date:2009-09-21
Last Update Date:2009-09-21
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
WAMA60104535225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist