Provider Demographics
NPI:1932429081
Name:LEMBURG, BRANDI MICHELLE (MA, LMP)
Entity Type:Individual
Prefix:MS
First Name:BRANDI
Middle Name:MICHELLE
Last Name:LEMBURG
Suffix:
Gender:F
Credentials:MA, LMP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2633 14TH AVE W
Mailing Address - Street 2:APT. 17
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98119-2177
Mailing Address - Country:US
Mailing Address - Phone:425-791-6821
Mailing Address - Fax:
Practice Address - Street 1:600 7TH AVE
Practice Address - Street 2:NO. 418
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98104-1914
Practice Address - Country:US
Practice Address - Phone:206-407-3068
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-06-10
Last Update Date:2010-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA60133694225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist