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NPI 1780702688

NPI 1780702688 : BRANDI L EDINGER LMP : SILVERDALE, WA

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General NPI Number Information
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    NPI Number           |    1780702688
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    Entity Type          |    Individual 
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    Provider Name        |    BRANDI L EDINGER LMP
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    03/27/2007
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    Last Update Date     |    06/25/2016
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Provider Practice Location Address
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    Address Line         |    9951 MICKELBERRY RD NW STE 215 
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    City                 |    SILVERDALE
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    State                |    WA
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    Zip                  |    98383-8309
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    Country              |    US
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    Telephone            |    360-801-5011
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    Fax                  |    360-208-0662
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Provider Business Mailing Address
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    Address Line         |    PO BOX 1453 
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    City                 |    ALLYN
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    State                |    WA
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    Zip                  |    98524
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    Country              |    US
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    Telephone            |    360-801-5011
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    Fax                  |    360-208-0662
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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       |    MA00020056
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    License Number State |    WA
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