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General NPI Number Information
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NPI Number | 1366087454
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Entity Type | Individual
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Provider Name | SHELBY RYAN BRIGGS LMT
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Gender | Female
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Dates
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Enumeration Date | 11/12/2019
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Last Update Date | 11/12/2019
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Provider Practice Location Address
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Address Line | 34 NE BOISTFORT ST STE 104
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City | CHEHALIS
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State | WA
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Zip | 98532-2600
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Country | US
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Telephone | 360-508-3450
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Fax |
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Provider Business Mailing Address
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Address Line | 151 SANDERSON RD
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City | CHEHALIS
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State | WA
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Zip | 98532-8620
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Country | US
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Telephone | 360-996-4940
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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 | 225700000X
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Taxonomy Name | Massage Therapist
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License Number | MA60999466
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License Number State | WA
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