Provider Demographics
NPI:1538605423
Name:DUSHARME, BRIANNE (MASSAGE THERAPIST)
Entity type:Individual
Prefix:
First Name:BRIANNE
Middle Name:
Last Name:DUSHARME
Suffix:
Gender:F
Credentials:MASSAGE THERAPIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5849 TACOMA MALL BLVD
Mailing Address - Street 2:
Mailing Address - City:TACOMA
Mailing Address - State:WA
Mailing Address - Zip Code:98409-6905
Mailing Address - Country:US
Mailing Address - Phone:253-475-6779
Mailing Address - Fax:
Practice Address - Street 1:5849 TACOMA MALL BLVD
Practice Address - Street 2:
Practice Address - City:TACOMA
Practice Address - State:WA
Practice Address - Zip Code:98409-6905
Practice Address - Country:US
Practice Address - Phone:253-475-6779
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-01-16
Last Update Date:2017-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA60675603172M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172M00000XOther Service ProvidersMechanotherapist