Provider Demographics
NPI:1629299474
Name:KARLBERG, BRYN ANNETTE (LMP)
Entity Type:Individual
Prefix:MS
First Name:BRYN
Middle Name:ANNETTE
Last Name:KARLBERG
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 1:12263 SHOREWOOD DRIVE SW
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98146
Mailing Address - Country:US
Mailing Address - Phone:206-715-0960
Mailing Address - Fax:
Practice Address - Street 1:12263 SHOREWOOD DRIVE SW
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98146
Practice Address - Country:US
Practice Address - Phone:206-715-0960
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA00021069225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist