Provider Demographics
NPI:1568424695
Name:AUGUST, BROOKE C (LAT, ATC)
Entity Type:Individual
Prefix:
First Name:BROOKE
Middle Name:C
Last Name:AUGUST
Suffix:
Gender:F
Credentials:LAT, ATC
Other - Prefix:
Other - First Name:BROOKE
Other - Middle Name:C
Other - Last Name:KEMEDY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:204 S COLLEGE AVE
Mailing Address - Street 2:
Mailing Address - City:COLLEGE PLACE
Mailing Address - State:WA
Mailing Address - Zip Code:99324-1198
Mailing Address - Country:US
Mailing Address - Phone:509-527-2475
Mailing Address - Fax:
Practice Address - Street 1:204 S COLLEGE AVE
Practice Address - Street 2:
Practice Address - City:COLLEGE PLACE
Practice Address - State:WA
Practice Address - Zip Code:99324-1198
Practice Address - Country:US
Practice Address - Phone:509-527-2475
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-04
Last Update Date:2022-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAA1600474072255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer