Will John Breen VI, AA

Primary specialty

Physical Therapy AssistantTaxonomy code 225200000X

License

WDL32ZB79173B Issued in WA

Practice address

6618 64TH St NE Ste D
Marysville, WA 98270-4883

Phone

(360) 653-5800

NPI assigned

Apr 22, 2024

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Associate of Arts

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Proaction Physical Therapy, PLLC

  • Physical Therapist
  • Marysville, WA
  • NPI 1689811770
  NPD

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

{
    "created_epoch": "1713744000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1713744000000",
    "number": "1457106684",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1416 E LAKESHORE DR",
            "city": "LAKE STEVENS",
            "state": "WA",
            "postal_code": "982588638",
            "telephone_number": "425-405-2313"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6618 64TH ST NE STE D",
            "city": "MARYSVILLE",
            "state": "WA",
            "postal_code": "982704883",
            "telephone_number": "360-653-5800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BREEN",
        "first_name": "WILL",
        "middle_name": "JOHN",
        "name_suffix": "VI",
        "credential": "AA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2024-04-22",
        "last_updated": "2024-04-22",
        "certification_date": "2024-04-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "WA",
            "license": "WDL32ZB79173B",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Deborah Bradley
• Radhika Brady, PTA
• Jenna Katherine Brammeier, DC
• Nissa Brandt, LMP
• Kristen Michelle Brashear, PSYD
• Shea M Breneman, D.C.
• Susan Lorrain Bridzell, LMP
• Candrea Bright
• Tracy Brigman, ARNP
• Jayla Elizabeth Brignac

• Physical Therapy Assistant in Marysville, WA
• Providers in Marysville, WA by specialty
• Physical Therapy Assistant in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 22, 2024; 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.