Provider Demographics
NPI:1598321705
Name:PEDERSON, BRITTNEY (LMT)
Entity Type:Individual
Prefix:MISS
First Name:BRITTNEY
Middle Name:
Last Name:PEDERSON
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:511 BOREN AVE N STE 301
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98109-5505
Mailing Address - Country:US
Mailing Address - Phone:206-324-5433
Mailing Address - Fax:206-324-1646
Practice Address - Street 1:511 BOREN AVE N STE 301
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98109-5505
Practice Address - Country:US
Practice Address - Phone:206-324-5433
Practice Address - Fax:206-324-1646
Is Sole Proprietor?:Yes
Enumeration Date:2019-05-13
Last Update Date:2019-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA60944429225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist