Provider Demographics
NPI:1164302667
Name:WEAVER, BRITTANY RENEE (MA61404816)
Entity type:Individual
Prefix:
First Name:BRITTANY
Middle Name:RENEE
Last Name:WEAVER
Suffix:
Gender:F
Credentials:MA61404816
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1607 N C ST
Mailing Address - Street 2:
Mailing Address - City:ABERDEEN
Mailing Address - State:WA
Mailing Address - Zip Code:98520-1446
Mailing Address - Country:US
Mailing Address - Phone:360-249-8421
Mailing Address - Fax:360-249-8545
Practice Address - Street 1:315 W MARCY AVE
Practice Address - Street 2:
Practice Address - City:MONTESANO
Practice Address - State:WA
Practice Address - Zip Code:98563-3618
Practice Address - Country:US
Practice Address - Phone:360-249-8421
Practice Address - Fax:360-249-8545
Is Sole Proprietor?:No
Enumeration Date:2025-09-04
Last Update Date:2025-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA61404816225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist