Doctor Name: | MR. BRIAN DAVID WORDEN |
NPI Number: | 1124367628 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | LMP |
License Number: | MA 60320485 |
Business Practice Address: | 2401 Bristol Ct Sw Suite A - 102 Olympia, WA - 985026003 |
Business Phone Number: | 3603500539 |
Business Fax Number: | 3605397336 |
Mailing Address: | 17144 Weaver Ln Sw, ROCHESTER |
State: | WA |
Postal Code: | 985799685 |
Phone Number: | 2064231592 |
Fax Number: | 3605397336 |
NPI Enumeration Date: | 02/05/2013 |
NPI Last Update Date: | 02/05/2013 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 225700000X |
License Number: | MA 60320485 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | WA |
Taxonomy Type: | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
Taxonomy Classification: | Massage Therapist |
Taxonomy Specialization: | |
Taxonomy Definition: | An individual trained in the manipulation of tissues (as by rubbing, stroking, kneading, or tapping) with the hand or an instrument for remedial or hygienic purposes. |