Provider Demographics
NPI:1184357782
Name:BRIMMER, SEJAHDAH BRIANNA (LSWAIC)
Entity type:Individual
Prefix:
First Name:SEJAHDAH
Middle Name:BRIANNA
Last Name:BRIMMER
Suffix:
Gender:F
Credentials:LSWAIC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7203 105TH AVE SW
Mailing Address - Street 2:
Mailing Address - City:OLYMPIA
Mailing Address - State:WA
Mailing Address - Zip Code:98512-8561
Mailing Address - Country:US
Mailing Address - Phone:360-349-7908
Mailing Address - Fax:
Practice Address - Street 1:719 SLEATER KINNEY RD SE
Practice Address - Street 2:
Practice Address - City:LACEY
Practice Address - State:WA
Practice Address - Zip Code:98503-1147
Practice Address - Country:US
Practice Address - Phone:360-528-0035
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-07-01
Last Update Date:2022-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WASC610387131041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical