Provider Demographics
NPI:1134474869
Name:MARKS, BRITTANY ELIZABETH WHEELER (DPT)
Entity type:Individual
Prefix:
First Name:BRITTANY
Middle Name:ELIZABETH WHEELER
Last Name:MARKS
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:BRITTANY
Other - Middle Name:ELIZABETH
Other - Last Name:WHEELER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:35 NW 1ST ST
Mailing Address - Street 2:
Mailing Address - City:COUPEVILLE
Mailing Address - State:WA
Mailing Address - Zip Code:98239
Mailing Address - Country:US
Mailing Address - Phone:360-678-1200
Mailing Address - Fax:360-678-1300
Practice Address - Street 1:35 NW 1ST STREET
Practice Address - Street 2:
Practice Address - City:COUPEVILLE
Practice Address - State:WA
Practice Address - Zip Code:98239
Practice Address - Country:US
Practice Address - Phone:360-678-1200
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-07-18
Last Update Date:2019-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPT60285973225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA2022802Medicaid