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NPI Code Detail

MEDICARE: DR. MARINA LEIGH BRISCOE D.P.T.

MEDICARE: DR. MARINA LEIGH BRISCOE D.P.T.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1225100000XPhysical Therapist1231678TX

General Provider Information

NPI Number : 1073947099
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. MARINA LEIGH BRISCOE D.P.T.
Provider Business Mailing Address
First Line : 22659 PACIFIC HWY S
Second Line : SUITE 201
City : DES MOINES
State : WA
Zip : 98198-5155
Country : US
Telephone Number : 206-824-3668
Fax Number : 206-824-3964
Provider Business Practice Location Address
First Line : 22659 PACIFIC HWY S
Second Line : SUITE 201
City : DES MOINES
State : WA
Zip : 98198-5155
Country : US
Telephone Number : 206-824-3668
Fax Number : 206-824-3964
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/27/2013
Last Update Date : 06/21/2016

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