Jacquelyne Brazell, LMP

Individual provider Active NPI Massage Therapist · Kennewick, WA

NPI 1245503267 · NPPES record last updated Feb 22, 2012

Key facts

NPI
1245503267
Entity type
Individual (NPI type 1)
Primary specialty
Massage Therapist 225700000X
License
MA60270020 (WA)
Practice address
8033 W Grandridge Blvd
Ste C
Kennewick, WA 99336-7159
Phone
(509) 783-1899
Fax
(509) 783-1898
NPI assigned
Feb 22, 2012
Sex
Female
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
MA60270020WAMDMassage Therapist

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Massage Therapist 225700000X MA60270020 WA Yes

Addresses

Primary practice location

8033 W Grandridge Blvd
Ste C
Kennewick, WA 99336-7159

Mailing address

8033 W Grandridge Blvd
Ste C
Kennewick, WA 99336-7159
Phone (509) 783-1899

Other providers in Kennewick, WA

All providers in Kennewick, WA · Massage Therapist in Washington

Sources for this page

Verify at the official NPI Registry.