Provider Demographics
NPI:1932618865
Name:WILLIAMS, BRITTANI MEGHAN (MA60796079)
Entity Type:Individual
Prefix:
First Name:BRITTANI
Middle Name:MEGHAN
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:MA60796079
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:83 KEENE RD
Mailing Address - Street 2:
Mailing Address - City:RICHLAND
Mailing Address - State:WA
Mailing Address - Zip Code:99352-5006
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:7514 W YELLOWSTONE AVE
Practice Address - Street 2:
Practice Address - City:KENNEWICK
Practice Address - State:WA
Practice Address - Zip Code:99336-1101
Practice Address - Country:US
Practice Address - Phone:509-783-7242
Practice Address - Fax:509-783-7286
Is Sole Proprietor?:No
Enumeration Date:2017-09-22
Last Update Date:2021-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA60796079225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WAMA60796079OtherMASSAGE