Provider Demographics
NPI:1518253061
Name:BRIGGS, STEFANIE (LMP)
Entity Type:Individual
Prefix:
First Name:STEFANIE
Middle Name:
Last Name:BRIGGS
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 1:2502 NW 8TH STREET
Mailing Address - Street 2:
Mailing Address - City:BATTLE GROUND
Mailing Address - State:WA
Mailing Address - Zip Code:98604
Mailing Address - Country:US
Mailing Address - Phone:360-281-0215
Mailing Address - Fax:360-687-8458
Practice Address - Street 1:113 S PARKWAY AVE
Practice Address - Street 2:
Practice Address - City:BATTLE GROUND
Practice Address - State:WA
Practice Address - Zip Code:98604-9294
Practice Address - Country:US
Practice Address - Phone:360-281-0215
Practice Address - Fax:360-687-8458
Is Sole Proprietor?:Yes
Enumeration Date:2011-06-23
Last Update Date:2020-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA00018696225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist