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Individual

BREANNA ROSE EDEN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
LMP

Contact information

Practice address
11430 51ST AVE NW STE 101A, GIG HARBOR, WA 98332-7897
(253) 857-6500
(253) 857-2225
Mailing address
17702 BASS LANE KP N, LAKEBAY, WA 98349-8121
(253) 884-9915

Taxonomy

Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
MA60303182
WA

Other

Enumeration date
10/03/2012
Last updated
10/03/2012
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