Provider Demographics
NPI:1922330430
Name:BREDL, JANET ANNE (LMP, RBT)
Entity Type:Individual
Prefix:MRS
First Name:JANET
Middle Name:ANNE
Last Name:BREDL
Suffix:
Gender:F
Credentials:LMP, RBT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:112 SW 157TH ST
Mailing Address - Street 2:
Mailing Address - City:BURIEN
Mailing Address - State:WA
Mailing Address - Zip Code:98166-2520
Mailing Address - Country:US
Mailing Address - Phone:206-595-3820
Mailing Address - Fax:
Practice Address - Street 1:112 SW 157TH ST
Practice Address - Street 2:
Practice Address - City:BURIEN
Practice Address - State:WA
Practice Address - Zip Code:98166-2520
Practice Address - Country:US
Practice Address - Phone:206-595-3820
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-02-08
Last Update Date:2010-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA60124206225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist