Provider Demographics
NPI:1437825494
Name:COOK, BRIANNA (PT, DPT)
Entity Type:Individual
Prefix:
First Name:BRIANNA
Middle Name:
Last Name:COOK
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3327 NE 1ST ST
Mailing Address - Street 2:
Mailing Address - City:BREMERTON
Mailing Address - State:WA
Mailing Address - Zip Code:98311-9674
Mailing Address - Country:US
Mailing Address - Phone:360-621-6074
Mailing Address - Fax:
Practice Address - Street 1:1950 POTTERY AVE STE 110
Practice Address - Street 2:
Practice Address - City:PORT ORCHARD
Practice Address - State:WA
Practice Address - Zip Code:98366-2501
Practice Address - Country:US
Practice Address - Phone:360-329-7052
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-08-19
Last Update Date:2021-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA61156581225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist