Provider Demographics
NPI:1720483571
Name:LENO, BRIANNA (MA)
Entity Type:Individual
Prefix:
First Name:BRIANNA
Middle Name:
Last Name:LENO
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2710 25TH AVENUE CT SE
Mailing Address - Street 2:
Mailing Address - City:PUYALLUP
Mailing Address - State:WA
Mailing Address - Zip Code:98374-4313
Mailing Address - Country:US
Mailing Address - Phone:253-324-3116
Mailing Address - Fax:
Practice Address - Street 1:2710 25TH AVENUE CT SE
Practice Address - Street 2:
Practice Address - City:PUYALLUP
Practice Address - State:WA
Practice Address - Zip Code:98374-4313
Practice Address - Country:US
Practice Address - Phone:253-324-3116
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-10-22
Last Update Date:2014-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA60504441225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist