Provider Demographics
NPI:1437800851
Name:BAILEY, ANDREW BRYAN (LMT)
Entity Type:Individual
Prefix:
First Name:ANDREW
Middle Name:BRYAN
Last Name:BAILEY
Suffix:
Gender:M
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3301 BURKE AVE N UNIT 315
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98103-9054
Mailing Address - Country:US
Mailing Address - Phone:206-414-9392
Mailing Address - Fax:
Practice Address - Street 1:3301 BURKE AVE N UNIT 315
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98103-9054
Practice Address - Country:US
Practice Address - Phone:206-414-9392
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-01-17
Last Update Date:2022-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA60179976225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist