Individual provider · Type 1 NPI

Fawndove O. Brubaker, LMT

Specialist · Vancouver, WA

NPI number 1659326304 Active

Practice location

12514 SE 7th St Apt B24
Vancouver, WA 98683-4075

Call (503) 490-4149 Map

Mailing address

19206 SE 1st St, Ste 118
Camas, WA 98607-7478

Specialties and licenses

TaxonomyCodeLicense
Massage Therapist 225700000X10892 (OR)
Specialist Primary 174400000XMA60242466 (WA)

Specialist: An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree.

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About NPI 1659326304

Fawndove O. Brubaker, LMT's National Provider Identifier is 1659326304, issued on May 23, 2006. The primary taxonomy on file is Specialist (174400000X), and the practice location is in Vancouver, WA. The record was last updated on Sep 14, 2012.