Brynn Fuller, MS ATC

Primary specialty

Athletic TrainerTaxonomy code 2255A2300X

License

A160860096 Issued in WA

Practice address

1101 Madison St Ste 800
Seattle, WA 98104-1307

Phone

(206) 316-3083

NPI assigned

Oct 20, 2016

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other names 1

• Brynn Lewis Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Science

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1476921600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1542067200000",
    "number": "1073064473",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "994 56TH ST APT 8",
            "city": "OAKLAND",
            "state": "CA",
            "postal_code": "946083132",
            "telephone_number": "206-310-7369"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1101 MADISON ST STE 800",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981041307",
            "telephone_number": "206-316-3083"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "751 NE Blakely Dr Ste 5010",
            "address_purpose": "LOCATION",
            "city": "Issaquah",
            "state": "WA",
            "postal_code": "980296201",
            "country_code": "US",
            "telephone_number": "206-310-7369",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FULLER",
        "first_name": "BRYNN",
        "name_prefix": "Mrs.",
        "credential": "MS ATC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-10-20",
        "last_updated": "2018-11-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "WA",
            "license": "A160860096",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "BRYNN",
            "last_name": "LEWIS",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Full Spectrum Testing
• Fullcircle
• Diane K. Fuller-Switzer, ARNP
• Angel M Fuller, SUDP-T
• Ashley E. Fuller, MD
• Caitlin Fuller, LMHCA, CDP
• Cameron Canton Fuller, LMP
• Claire Frances Fuller
• Jessica L Fuller
• Leilani Marie Fuller, RN

• Athletic Trainer in Seattle, WA
• Providers in Seattle, WA by specialty
• Athletic Trainer in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 13, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.