Provider Demographics
NPI:1962633768
Name:ISAACKS, BRITNII LEIGH-ANNE (LMT)
Entity Type:Individual
Prefix:
First Name:BRITNII
Middle Name:LEIGH-ANNE
Last Name:ISAACKS
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3488 PECK AVE SE
Mailing Address - Street 2:
Mailing Address - City:SALEM
Mailing Address - State:OR
Mailing Address - Zip Code:97302-3312
Mailing Address - Country:US
Mailing Address - Phone:503-857-8196
Mailing Address - Fax:
Practice Address - Street 1:3488 PECK AVE SE
Practice Address - Street 2:
Practice Address - City:SALEM
Practice Address - State:MARION
Practice Address - Zip Code:97302
Practice Address - Country:UM
Practice Address - Phone:503-857-8196
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-07-29
Last Update Date:2009-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR15091175L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175L00000XOther Service ProvidersHomeopath