Provider Demographics
NPI:1518448976
Name:BREKKE, DAWN NEWMAN (PT)
Entity Type:Individual
Prefix:
First Name:DAWN
Middle Name:NEWMAN
Last Name:BREKKE
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14512 E 45TH CT
Mailing Address - Street 2:
Mailing Address - City:VERADALE
Mailing Address - State:WA
Mailing Address - Zip Code:99037-9143
Mailing Address - Country:US
Mailing Address - Phone:509-951-2339
Mailing Address - Fax:
Practice Address - Street 1:3600 E HARTSON AVE
Practice Address - Street 2:
Practice Address - City:SPOKANE
Practice Address - State:WA
Practice Address - Zip Code:99202-5199
Practice Address - Country:US
Practice Address - Phone:509-535-2071
Practice Address - Fax:509-534-6088
Is Sole Proprietor?:No
Enumeration Date:2018-08-23
Last Update Date:2018-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPT00003984225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WAPT00003984OtherPHYSICAL THERAPY LICENSE