Provider Demographics
NPI:1346041431
Name:LITTLE BRAVE, MARY FRANCES (LMT)
Entity type:Individual
Prefix:
First Name:MARY
Middle Name:FRANCES
Last Name:LITTLE BRAVE
Suffix:
Gender:
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3213 63RD AVE SW
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98116-2710
Mailing Address - Country:US
Mailing Address - Phone:828-775-2412
Mailing Address - Fax:
Practice Address - Street 1:2237 CALIFORNIA AVE SW
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98116-2111
Practice Address - Country:US
Practice Address - Phone:206-617-3454
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-03-24
Last Update Date:2025-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA000012854225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist