Healthcare Provider Details

I. General information

NPI: 1679407969
Provider Name (Legal Business Name): BRITTA KULLA MA 61590382
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/11/2026
Last Update Date: 06/11/2026
Certification Date: 06/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12420 NW 36TH AVE
VANCOUVER WA
98685-2225
US

IV. Provider business mailing address

16004 NE 119TH ST
BRUSH PRAIRIE WA
98606-7105
US

V. Phone/Fax

Practice location:
  • Phone: 360-450-1331
  • Fax:
Mailing address:
  • Phone: 360-953-1212
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225700000X
TaxonomyMassage Therapist
License Number61590382
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: