Provider Demographics
NPI:1700209483
Name:AUBREY, EMILY
Entity Type:Individual
Prefix:
First Name:EMILY
Middle Name:
Last Name:AUBREY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:19527 SE 237TH ST
Mailing Address - Street 2:
Mailing Address - City:MAPLE VALLEY
Mailing Address - State:WA
Mailing Address - Zip Code:98038-8614
Mailing Address - Country:US
Mailing Address - Phone:425-351-1233
Mailing Address - Fax:
Practice Address - Street 1:18230 SE 240TH ST
Practice Address - Street 2:
Practice Address - City:COVINGTON
Practice Address - State:WA
Practice Address - Zip Code:98042-4818
Practice Address - Country:US
Practice Address - Phone:425-351-1233
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-01-30
Last Update Date:2014-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer
Provider Identifiers
StateIdentifier IDID TypeIssuer
WAAUBREEF234R4OtherDRIVERS LICENSE