Basic Information
| Provider Information | |||||||||
| NPI: | 1932656287 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | BRIANT | ||||||||
| FirstName: | JENNIFER | ||||||||
| MiddleName: | ROSE | ||||||||
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| Credential: | DPT | ||||||||
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| Mailing Information | |||||||||
| Address1: | 805 MADISON ST | ||||||||
| Address2: | SUITE 901 | ||||||||
| City: | SEATTLE | ||||||||
| State: | WA | ||||||||
| PostalCode: | 981041172 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2062648100 | ||||||||
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| Practice Location | |||||||||
| Address1: | 1200 112TH AVE NE | ||||||||
| Address2: | SUITE C260 | ||||||||
| City: | BELLEVUE | ||||||||
| State: | WA | ||||||||
| PostalCode: | 980043732 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4254625006 | ||||||||
| FaxNumber: | 4254625019 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 09/03/2016 | ||||||||
| LastUpdateDate: | 09/03/2016 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 225100000X | PT60657463 | WA | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist |
No ID Information.