Individual
MR. JEFFREY R BRESNAHAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MPT, DPT
Contact information
Practice address
12509 E. MISSION AVE., STE. 202, SPOKANE, WA 99216
(509) 444-5678
Mailing address
16083 SW UPPER BOONES FERRY RD, SUITE 300, TIGARD, OR 97224-7736
(800) 219-8835
(503) 639-9699
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT 00009538
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
8422628
—
WA
01
—
P007047019
RR MEDICARE
WA
01
—
P00704709
RR MEDICARE
WA
Enumeration date
10/06/2006
Last updated
11/01/2012
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