Provider Demographics
NPI:1427222579
Name:BRIDGES, SYDNEY ELIZABETH (LMP)
Entity Type:Individual
Prefix:MS
First Name:SYDNEY
Middle Name:ELIZABETH
Last Name:BRIDGES
Suffix:
Gender:F
Credentials:LMP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:311 TAHUYEH PL W
Mailing Address - Street 2:
Mailing Address - City:BREMERTON
Mailing Address - State:WA
Mailing Address - Zip Code:98312-7604
Mailing Address - Country:US
Mailing Address - Phone:360-621-2925
Mailing Address - Fax:
Practice Address - Street 1:2817 WHEATON WAY
Practice Address - Street 2:SUITE 104-C
Practice Address - City:BREMERTON
Practice Address - State:WA
Practice Address - Zip Code:98310-3440
Practice Address - Country:US
Practice Address - Phone:360-377-0725
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-04-19
Last Update Date:2008-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA12653225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist