Provider Demographics
NPI:1467344317
Name:TOLEDO-BUSTILLO, BRIANNEN MELISSA
Entity type:Individual
Prefix:
First Name:BRIANNEN
Middle Name:MELISSA
Last Name:TOLEDO-BUSTILLO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:BRIANNEN
Other - Middle Name:
Other - Last Name:TOLEDO
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:35047 37TH AVE S
Mailing Address - Street 2:
Mailing Address - City:AUBURN
Mailing Address - State:WA
Mailing Address - Zip Code:98001-9051
Mailing Address - Country:US
Mailing Address - Phone:253-508-2170
Mailing Address - Fax:
Practice Address - Street 1:8725 S 212TH ST
Practice Address - Street 2:
Practice Address - City:KENT
Practice Address - State:WA
Practice Address - Zip Code:98031-1921
Practice Address - Country:US
Practice Address - Phone:253-508-2170
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-07-16
Last Update Date:2025-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician