Provider Demographics
NPI:1639731755
Name:BRYSON, BREEANN DELYNN
Entity type:Individual
Prefix:
First Name:BREEANN
Middle Name:DELYNN
Last Name:BRYSON
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:324 W BAY DR NW STE 216
Mailing Address - Street 2:
Mailing Address - City:OLYMPIA
Mailing Address - State:WA
Mailing Address - Zip Code:98502-4926
Mailing Address - Country:US
Mailing Address - Phone:360-790-4201
Mailing Address - Fax:360-584-9248
Practice Address - Street 1:324 W BAY DR NW STE 216
Practice Address - Street 2:
Practice Address - City:OLYMPIA
Practice Address - State:WA
Practice Address - Zip Code:98502-4926
Practice Address - Country:US
Practice Address - Phone:360-790-4201
Practice Address - Fax:360-584-9248
Is Sole Proprietor?:Yes
Enumeration Date:2019-06-28
Last Update Date:2025-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YM0800X
WALH61354525101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health