Fawndove O Brubaker, LMT

Primary specialty

SpecialistTaxonomy code 174400000X

License

MA60242466 Issued in WA

Practice address

12514 SE 7TH St Apt B24
Vancouver, WA 98683-4075

Phone

(503) 490-4149

NPI assigned

May 23, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1148342400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1347580800000",
    "number": "1659326304",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19206 SE 1ST ST",
            "address_2": "STE 118",
            "city": "CAMAS",
            "state": "WA",
            "postal_code": "986077478",
            "telephone_number": "503-490-4149"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12514 SE 7TH ST APT B24",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986834075",
            "telephone_number": "503-490-4149"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRUBAKER",
        "first_name": "FAWNDOVE",
        "middle_name": "O",
        "credential": "LMT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-23",
        "last_updated": "2012-09-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "OR",
            "license": "10892",
            "primary": false
        },
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "WA",
            "license": "MA60242466",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Cynthia Ann Browne
• Jacqueline Christine Browning, LCSW, LICSW
• Margaret Browning
• Kelley Ann Brownlie, LMP
• Dustin M Brubaker, LMP, CMT
• Alexandra Brucculeri, SLP
• Tyla Bruce, CBT
• Kathleen Mary Bruhn, PH.D.
• Pamela Suzanne Bruhn, ARNP
• Talia Brumfield, AA

• Specialist in Vancouver, WA
• Providers in Vancouver, WA by specialty
• Specialist in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 14, 2012; 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.