Provider Demographics
NPI:1942040548
Name:O'MALLEY, BRIANNA LYNN (PT, DPT)
Entity type:Individual
Prefix:
First Name:BRIANNA
Middle Name:LYNN
Last Name:O'MALLEY
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:BRIANNA
Other - Middle Name:LYNN
Other - Last Name:SMITH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2396 230TH PL SW
Mailing Address - Street 2:
Mailing Address - City:BRIER
Mailing Address - State:WA
Mailing Address - Zip Code:98036-8395
Mailing Address - Country:US
Mailing Address - Phone:425-346-5233
Mailing Address - Fax:
Practice Address - Street 1:334 S 13TH ST
Practice Address - Street 2:
Practice Address - City:BURLINGTON
Practice Address - State:CO
Practice Address - Zip Code:80807-2414
Practice Address - Country:US
Practice Address - Phone:719-346-6050
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-05-30
Last Update Date:2024-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPT61561650225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist