Provider Demographics
NPI:1669528667
Name:BRILL, VICTORIA DEANNA (LAC, LMP, RC)
Entity type:Individual
Prefix:MS
First Name:VICTORIA
Middle Name:DEANNA
Last Name:BRILL
Suffix:
Gender:F
Credentials:LAC, LMP, RC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1411 4TH AVE
Mailing Address - Street 2:SUITE #1322
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98101-2249
Mailing Address - Country:US
Mailing Address - Phone:206-623-1630
Mailing Address - Fax:
Practice Address - Street 1:1411 4TH AVE
Practice Address - Street 2:SUITE #1322
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98101-2249
Practice Address - Country:US
Practice Address - Phone:206-623-1630
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MIAC00000461171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist