Provider Demographics
NPI:1205469467
Name:MASSEY, BROOKE CHRISTINA-MARIE (PSYD)
Entity type:Individual
Prefix:DR
First Name:BROOKE
Middle Name:CHRISTINA-MARIE
Last Name:MASSEY
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1903 NW 144TH ST
Mailing Address - Street 2:
Mailing Address - City:VANCOUVER
Mailing Address - State:WA
Mailing Address - Zip Code:98685-8000
Mailing Address - Country:US
Mailing Address - Phone:206-356-8467
Mailing Address - Fax:
Practice Address - Street 1:10000 NE 7TH AVE STE 215
Practice Address - Street 2:
Practice Address - City:VANCOUVER
Practice Address - State:WA
Practice Address - Zip Code:98685-4542
Practice Address - Country:US
Practice Address - Phone:360-574-9565
Practice Address - Fax:360-574-9685
Is Sole Proprietor?:No
Enumeration Date:2020-02-17
Last Update Date:2020-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPY60714657103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical