Provider Demographics
NPI:1750773925
Name:PARRINO, BRYON (LMP)
Entity type:Individual
Prefix:
First Name:BRYON
Middle Name:
Last Name:PARRINO
Suffix:
Gender:M
Credentials:LMP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5 APPELO LN
Mailing Address - Street 2:
Mailing Address - City:NASELLE
Mailing Address - State:WA
Mailing Address - Zip Code:98638-8507
Mailing Address - Country:US
Mailing Address - Phone:360-484-3550
Mailing Address - Fax:
Practice Address - Street 1:5 APPELO LN
Practice Address - Street 2:
Practice Address - City:NASELLE
Practice Address - State:WA
Practice Address - Zip Code:98638-8507
Practice Address - Country:US
Practice Address - Phone:360-484-3550
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-02-25
Last Update Date:2015-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA 60242182225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist