Provider Demographics
NPI:1558669283
Name:HUGHES, BRANDI JOANN (LMP)
Entity Type:Individual
Prefix:
First Name:BRANDI
Middle Name:JOANN
Last Name:HUGHES
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 1:417 WILSON ST SE
Mailing Address - Street 2:
Mailing Address - City:OLYMPIA
Mailing Address - State:WA
Mailing Address - Zip Code:98501-1946
Mailing Address - Country:US
Mailing Address - Phone:360-280-8506
Mailing Address - Fax:
Practice Address - Street 1:417 WILSON ST SE
Practice Address - Street 2:
Practice Address - City:OLYMPIA
Practice Address - State:WA
Practice Address - Zip Code:98501-1946
Practice Address - Country:US
Practice Address - Phone:360-280-8506
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-03-03
Last Update Date:2011-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA60210854225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist