Provider Demographics
NPI:1144918954
Name:KING, BRITTANY M
Entity type:Individual
Prefix:
First Name:BRITTANY
Middle Name:M
Last Name:KING
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1839 NE 104TH LOOP APT 7
Mailing Address - Street 2:
Mailing Address - City:VANCOUVER
Mailing Address - State:WA
Mailing Address - Zip Code:98686-5409
Mailing Address - Country:US
Mailing Address - Phone:360-210-9130
Mailing Address - Fax:
Practice Address - Street 1:1839 NE 104TH LOOP APT 7
Practice Address - Street 2:
Practice Address - City:VANCOUVER
Practice Address - State:WA
Practice Address - Zip Code:98686-5409
Practice Address - Country:US
Practice Address - Phone:360-210-9130
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-04-28
Last Update Date:2023-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician