Active NPI
Breena Sue Hirsch, PTA
- Physical Therapy Assistant
- Puyallup, WA
National Provider Identifier
1407014566
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapy Assistant
- License
- 1776
- Practice address
- 920 12TH Ave SE
Puyallup, WA 98372-4920 - Phone
- (253) 841-3422
- NPI assigned
- May 27, 2008
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapy Assistant | 225200000X | 1776 | AK | Primary |
Addresses
Primary practice location
920 12TH Ave SE
Puyallup, WA 98372-4920
Mailing address
11104 184TH Avenue PL E
Bonney Lake, WA 98391-6044
Phone (253) 862-4708
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1776 | AK | MD | Physical Therapy Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1211846400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1211846400000",
"number": "1407014566",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "11104 184TH AVENUE PL E",
"city": "BONNEY LAKE",
"state": "WA",
"postal_code": "983916044",
"telephone_number": "253-862-4708"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "920 12TH AVE SE",
"city": "PUYALLUP",
"state": "WA",
"postal_code": "983724920",
"telephone_number": "253-841-3422"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HIRSCH",
"first_name": "BREENA",
"middle_name": "SUE",
"name_prefix": "Mrs.",
"credential": "PTA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2008-05-27",
"last_updated": "2008-05-27",
"status": "A"
},
"taxonomies": [
{
"code": "225200000X",
"taxonomy_group": "",
"desc": "Physical Therapy Assistant",
"state": "AK",
"license": "1776",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Puyallup, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 27, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.