Provider Demographics
NPI:1134531874
Name:ANDREWS, BROOKE MIKEL (LMT)
Entity type:Individual
Prefix:
First Name:BROOKE
Middle Name:MIKEL
Last Name:ANDREWS
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 1:1838 ROSEWOOD LN
Mailing Address - Street 2:
Mailing Address - City:BELLINGHAM
Mailing Address - State:WA
Mailing Address - Zip Code:98225-7400
Mailing Address - Country:US
Mailing Address - Phone:720-276-8905
Mailing Address - Fax:
Practice Address - Street 1:1050 LARRABEE AVE
Practice Address - Street 2:#205
Practice Address - City:BELLINGHAM
Practice Address - State:WA
Practice Address - Zip Code:98225-7367
Practice Address - Country:US
Practice Address - Phone:720-276-8905
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-05-29
Last Update Date:2014-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA60423878225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist