Healthcare Provider Details

I. General information

NPI: 1497402192
Provider Name (Legal Business Name): ADDISON BREIER
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: ADDE BREIER

II. Dates (important events)

Enumeration Date: 03/03/2022
Last Update Date: 07/25/2026
Certification Date: 07/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

19004 127TH PL SE
RENTON WA
98058-7907
US

IV. Provider business mailing address

19004 127TH PL SE
RENTON WA
98058-7907
US

V. Phone/Fax

Practice location:
  • Phone: 541-944-9396
  • Fax:
Mailing address:
  • Phone: 541-944-9396
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code374J00000X
TaxonomyDoula
License NumberBDC.BD.70077640
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: