Provider Demographics
NPI:1689814303
Name:BRINITZER, ANN MICHELE (LMP)
Entity Type:Individual
Prefix:
First Name:ANN
Middle Name:MICHELE
Last Name:BRINITZER
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 1:4780 NETTLE LN
Mailing Address - Street 2:
Mailing Address - City:BELLINGHAM
Mailing Address - State:WA
Mailing Address - Zip Code:98226-9749
Mailing Address - Country:US
Mailing Address - Phone:360-398-8110
Mailing Address - Fax:
Practice Address - Street 1:3120 SQUALICUM PKWY STE 2
Practice Address - Street 2:
Practice Address - City:BELLINGHAM
Practice Address - State:WA
Practice Address - Zip Code:98225-1934
Practice Address - Country:US
Practice Address - Phone:360-739-8497
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-02-21
Last Update Date:2009-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA12910172M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172M00000XOther Service ProvidersMechanotherapist