Provider Demographics
NPI:1770996159
Name:BRAZZALE, SYDNEY (DPT)
Entity type:Individual
Prefix:DR
First Name:SYDNEY
Middle Name:
Last Name:BRAZZALE
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:19801 N CREEK PKWY STE 200
Mailing Address - Street 2:
Mailing Address - City:BOTHELL
Mailing Address - State:WA
Mailing Address - Zip Code:98011-8240
Mailing Address - Country:US
Mailing Address - Phone:425-984-2645
Mailing Address - Fax:
Practice Address - Street 1:19801 N CREEK PKWY STE 200
Practice Address - Street 2:
Practice Address - City:BOTHELL
Practice Address - State:WA
Practice Address - Zip Code:98011-8240
Practice Address - Country:US
Practice Address - Phone:425-984-2645
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-06-03
Last Update Date:2024-11-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPT607350302251P0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251P0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistPediatrics