Healthcare Provider Details

I. General information

NPI: 1932531217
Provider Name (Legal Business Name): HEATHER BRUMMER MS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/08/2013
Last Update Date: 08/08/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1904 3RD AVE STE 918
SEATTLE WA
98101-1126
US

IV. Provider business mailing address

4001 164TH PL SW
LYNNWOOD WA
98037-9503
US

V. Phone/Fax

Practice location:
  • Phone: 206-595-0376
  • Fax:
Mailing address:
  • Phone: 425-269-1989
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code133N00000X
TaxonomyNutritionist
License NumberNU 00001454
License Number StateWA
# 2
Primary TaxonomyN
Taxonomy Code171100000X
TaxonomyAcupuncturist
License NumberAC 00002642
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: