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General NPI Number Information
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NPI Number | 1073062980
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Entity Type | Individual
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Provider Name | DAVID LOUIS BREEN PSYD
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Gender | Male
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Dates
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Enumeration Date | 10/04/2016
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Last Update Date | 03/12/2021
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Provider Practice Location Address
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Address Line | MADIGAN ARMY MEDICAL CENTER 9040 JACKSON AVE
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City | TACOMA
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State | WA
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Zip | 98431-1000
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Country | US
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Telephone | 978-399-4168
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Fax |
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Provider Business Mailing Address
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Address Line | 2136 MARQUEE LN
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City | FUQUAY VARINA
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State | NC
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Zip | 27526-3207
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Country | US
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Telephone | 978-399-4168
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Fax |
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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 | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | 60819590
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License Number State | WA
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