Provider Demographics
NPI:1588989123
Name:BRYANT, CATHERINE (LMP)
Entity type:Individual
Prefix:
First Name:CATHERINE
Middle Name:
Last Name:BRYANT
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 2651
Mailing Address - Street 2:
Mailing Address - City:GIG HARBOR
Mailing Address - State:WA
Mailing Address - Zip Code:98335-4651
Mailing Address - Country:US
Mailing Address - Phone:206-291-3109
Mailing Address - Fax:
Practice Address - Street 1:7201 PIONEER WAY
Practice Address - Street 2:STE B 201
Practice Address - City:GIG HARBOR
Practice Address - State:WA
Practice Address - Zip Code:98335-1161
Practice Address - Country:US
Practice Address - Phone:206-291-3109
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-04-06
Last Update Date:2011-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA 60099593225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist