Provider Demographics
NPI:1811368582
Name:AUBREY, BRANDI (LMP)
Entity Type:Individual
Prefix:
First Name:BRANDI
Middle Name:
Last Name:AUBREY
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 1:21810 1ST PL W
Mailing Address - Street 2:
Mailing Address - City:BOTHELL
Mailing Address - State:WA
Mailing Address - Zip Code:98021-8269
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:10116 MAIN ST
Practice Address - Street 2:SUITE #103
Practice Address - City:BOTHELL
Practice Address - State:WA
Practice Address - Zip Code:98011-3400
Practice Address - Country:US
Practice Address - Phone:206-470-0792
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-10-07
Last Update Date:2015-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA 0001599225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist