Healthcare Provider Details

I. General information

NPI: 1265402564
Provider Name (Legal Business Name): BRITNEY GRIMES FRAZIER MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: BRITNEY LYNN GRIMES

II. Dates (important events)

Enumeration Date: 01/26/2006
Last Update Date: 10/30/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

311 S L ST
TACOMA WA
98405-3720
US

IV. Provider business mailing address

311 S L ST
TACOMA WA
98405-3720
US

V. Phone/Fax

Practice location:
  • Phone: 253-792-6630
  • Fax:
Mailing address:
  • Phone: 253-792-6630
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number01054799A
License Number StateIN
# 2
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberMD60322363
License Number StateWA
# 3
Primary TaxonomyY
Taxonomy Code2080P0205X
TaxonomyPediatric Endocrinology Physician
License NumberMD60322363
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: