Provider Demographics
NPI:1336550854
Name:WALLIN, BRITTNEY
Entity Type:Individual
Prefix:
First Name:BRITTNEY
Middle Name:
Last Name:WALLIN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1355 WASHINGTON AVE
Mailing Address - Street 2:
Mailing Address - City:OSHKOSH
Mailing Address - State:WI
Mailing Address - Zip Code:54901-5359
Mailing Address - Country:US
Mailing Address - Phone:425-351-8098
Mailing Address - Fax:
Practice Address - Street 1:12606 100TH AVE NE
Practice Address - Street 2:I-143
Practice Address - City:KIRKLAND
Practice Address - State:WA
Practice Address - Zip Code:98034-2727
Practice Address - Country:US
Practice Address - Phone:425-218-5799
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-05-19
Last Update Date:2023-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst