Provider Demographics
NPI:1124260922
Name:BUZARD, BRITTANY JEAN (LMP)
Entity type:Individual
Prefix:MISS
First Name:BRITTANY
Middle Name:JEAN
Last Name:BUZARD
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 1:6101 51ST AVE NW
Mailing Address - Street 2:
Mailing Address - City:GIG HARBOR
Mailing Address - State:WA
Mailing Address - Zip Code:98335-7349
Mailing Address - Country:US
Mailing Address - Phone:253-722-3100
Mailing Address - Fax:
Practice Address - Street 1:5800 SOUNDVIEW DR
Practice Address - Street 2:SUITE C-101
Practice Address - City:GIG HARBOR
Practice Address - State:WA
Practice Address - Zip Code:98335-2000
Practice Address - Country:US
Practice Address - Phone:253-858-4845
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-03-26
Last Update Date:2009-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA 60058642225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist