Provider Demographics
NPI:1508315888
Name:BRASSFIELD, GABRIELLE (LMP)
Entity Type:Individual
Prefix:MISS
First Name:GABRIELLE
Middle Name:
Last Name:BRASSFIELD
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 1:7503 196TH ST SW
Mailing Address - Street 2:
Mailing Address - City:LYNNWOOD
Mailing Address - State:WA
Mailing Address - Zip Code:98036-5079
Mailing Address - Country:US
Mailing Address - Phone:425-775-8000
Mailing Address - Fax:425-775-8221
Practice Address - Street 1:7503 196TH ST SW
Practice Address - Street 2:
Practice Address - City:LYNNWOOD
Practice Address - State:WA
Practice Address - Zip Code:98036-5079
Practice Address - Country:US
Practice Address - Phone:425-775-8000
Practice Address - Fax:425-775-8221
Is Sole Proprietor?:No
Enumeration Date:2016-09-27
Last Update Date:2016-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA60695319225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist