Provider Demographics
NPI:1518187954
Name:BREILER, LINDAMARIE (LMP)
Entity Type:Individual
Prefix:MRS
First Name:LINDAMARIE
Middle Name:
Last Name:BREILER
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 1:777 ROAD S SW
Mailing Address - Street 2:
Mailing Address - City:EAST WENATCHEE
Mailing Address - State:WA
Mailing Address - Zip Code:98802-8267
Mailing Address - Country:US
Mailing Address - Phone:509-884-1228
Mailing Address - Fax:509-884-1228
Practice Address - Street 1:127 METHOW ST UNIT B
Practice Address - Street 2:
Practice Address - City:WENATCHEE
Practice Address - State:WA
Practice Address - Zip Code:98801-6923
Practice Address - Country:US
Practice Address - Phone:509-663-9878
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WAMA00019798OtherMASSAGE PRACTITIONER