Provider Demographics
NPI:1558415612
Name:BROWNFIELD, CYNTHIA J (LMP)
Entity Type:Individual
Prefix:
First Name:CYNTHIA
Middle Name:J
Last Name:BROWNFIELD
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 1:6506 WOLLOCHET DR NW
Mailing Address - Street 2:
Mailing Address - City:GIG HARBOR
Mailing Address - State:WA
Mailing Address - Zip Code:98335-8319
Mailing Address - Country:US
Mailing Address - Phone:253-222-8648
Mailing Address - Fax:253-858-1552
Practice Address - Street 1:6506 WOLLOCHET DR NW
Practice Address - Street 2:
Practice Address - City:GIG HARBOR
Practice Address - State:WA
Practice Address - Zip Code:98335-8319
Practice Address - Country:US
Practice Address - Phone:253-222-8648
Practice Address - Fax:253-858-1552
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-23
Last Update Date:2011-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA00015236225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA9022BROtherREGENCE