MEDICARE: BROOKE M NOEL LMT

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
1	172M00000X	Mechanotherapist	60219958	WA

General Provider Information

NPI Number	:	1326332602
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BROOKE M NOEL LMT

Provider Business Mailing Address
First Line	:	2900 S KING ST
Second Line	:	APT. 103
City	:	SEATTLE
State	:	WA
Zip	:	98144-2551
Country	:	US
Telephone Number	:	206-601-8011
Fax Number	:

Provider Business Practice Location Address
First Line	:	2900 S KING ST
Second Line	:	APT. 103
City	:	SEATTLE
State	:	WA
Zip	:	98144-2551
Country	:	US
Telephone Number	:	206-601-8011
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/04/2011
Last Update Date	:	06/04/2011

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