=====================================================
General NPI Number Information
=====================================================
NPI Number | 1538594767
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | BRITTANY ANN SCHWAB MT
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 09/06/2013
-----------------------------------------------------
Last Update Date | 03/13/2017
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 2200 S MAIERS RD SUITE B
-----------------------------------------------------
City | MOSES LAKE
-----------------------------------------------------
State | WA
-----------------------------------------------------
Zip | 98837-8818
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 509-764-8626
-----------------------------------------------------
Fax | 509-764-8628
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 2200 S MAIERS RD SUITE B
-----------------------------------------------------
City | MOSES LAKE
-----------------------------------------------------
State | WA
-----------------------------------------------------
Zip | 98837-8818
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 509-764-8626
-----------------------------------------------------
Fax | 509-764-8628
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 225700000X
-----------------------------------------------------
Taxonomy Name | Massage Therapist
-----------------------------------------------------
License Number | MA60402624
-----------------------------------------------------
License Number State | WA
-----------------------------------------------------