Provider Demographics
NPI:1982064879
Name:BREWSTER, PATRICIA LEEANN (LMT, CAHC, RYT, BSPE)
Entity Type:Individual
Prefix:
First Name:PATRICIA
Middle Name:LEEANN
Last Name:BREWSTER
Suffix:
Gender:F
Credentials:LMT, CAHC, RYT, BSPE
Other - Prefix:
Other - First Name:LEEANN
Other - Middle Name:
Other - Last Name:BREWSTER
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LMT, CAHC, RYT, BSPE
Mailing Address - Street 1:PO BOX 200579
Mailing Address - Street 2:
Mailing Address - City:ANCHORAGE
Mailing Address - State:AK
Mailing Address - Zip Code:99520-0579
Mailing Address - Country:US
Mailing Address - Phone:907-575-7411
Mailing Address - Fax:844-965-9093
Practice Address - Street 1:5313 ARCTIC BLVD STE 200B
Practice Address - Street 2:
Practice Address - City:ANCHORAGE
Practice Address - State:AK
Practice Address - Zip Code:99518-1111
Practice Address - Country:US
Practice Address - Phone:907-575-7411
Practice Address - Fax:844-965-9093
Is Sole Proprietor?:Yes
Enumeration Date:2016-03-04
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist