Provider Demographics
NPI:1316353451
Name:BOYD, BRITTNEY NICOLE (LMP)
Entity type:Individual
Prefix:MISS
First Name:BRITTNEY
Middle Name:NICOLE
Last Name:BOYD
Suffix:
Gender:F
Credentials:LMP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 14632
Mailing Address - Street 2:
Mailing Address - City:SPOKANE VALLEY
Mailing Address - State:WA
Mailing Address - Zip Code:99214-0632
Mailing Address - Country:US
Mailing Address - Phone:509-216-3576
Mailing Address - Fax:
Practice Address - Street 1:12903 E SPRAGUE AVE APT 14
Practice Address - Street 2:
Practice Address - City:SPOKANE VALLEY
Practice Address - State:WA
Practice Address - Zip Code:99216-0736
Practice Address - Country:US
Practice Address - Phone:509-216-3576
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-07-09
Last Update Date:2014-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA60471205225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist