Provider Demographics
NPI:1265081566
Name:BRISKEY, KAREN KAY (LMT, LAMT, SAMT)
Entity type:Individual
Prefix:MISS
First Name:KAREN
Middle Name:KAY
Last Name:BRISKEY
Suffix:
Gender:F
Credentials:LMT, LAMT, SAMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:403 43RD AVE SW APT 1
Mailing Address - Street 2:
Mailing Address - City:PUYALLUP
Mailing Address - State:WA
Mailing Address - Zip Code:98373-5965
Mailing Address - Country:US
Mailing Address - Phone:253-297-3561
Mailing Address - Fax:
Practice Address - Street 1:403 43RD AVE SW APT 1
Practice Address - Street 2:
Practice Address - City:PUYALLUP
Practice Address - State:WA
Practice Address - Zip Code:98373-5965
Practice Address - Country:US
Practice Address - Phone:253-297-3561
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-09-09
Last Update Date:2019-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA00020202225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist