Individual
WILL JOHN BREEN VI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
AA
Contact information
Practice address
6618 64TH ST NE STE D, MARYSVILLE, WA 98270-4883
(360) 653-5800
Mailing address
1416 E LAKESHORE DR, LAKE STEVENS, WA 98258-8638
(425) 405-2313
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
WDL32ZB79173B
WA
Other
Enumeration date
04/22/2024
Last updated
04/22/2024
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