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General NPI Number Information
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NPI Number | 1033742804
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Entity Type | Individual
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Provider Name | CIERA JOY BRECTO PTA
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Gender | Female
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Dates
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Enumeration Date | 02/19/2020
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Last Update Date | 02/19/2020
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Provider Practice Location Address
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Address Line | 1455 NW LEARY WAY STE 150
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City | SEATTLE
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State | WA
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Zip | 98107-5140
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Country | US
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Telephone | 206-782-0218
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Fax | 206-782-1892
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Provider Business Mailing Address
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Address Line | 1455 NW LEARY WAY STE 150
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City | SEATTLE
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State | WA
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Zip | 98107-5140
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Country | US
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Telephone | 206-782-0218
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Fax | 206-782-1892
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225200000X
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Taxonomy Name | Physical Therapy Assistant
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License Number | 61002244
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License Number State | WA
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