TED BRACKMAN (NPI# 1861723553) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1861723553 |
| Entity Type | Individual |
| Full Name | TED BRACKMAN |
| Credential | MA, M.DIV. |
| Practice Address |
11019 Canyon Rd E Puyallup WA 98373-3001 |
| Practice Telephone | 2535381310 |
| Mailing Telephone | 2535381310 |
| Enumeration Date | 2010-01-20 |
| Last Update Date | 2010-01-20 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101YM0800X |
Counselor Specialization: Mental Health |
LH00006310 | WA | Behavioral Health & Social Service Providers |
| N | 106H00000X | Marriage & Family Therapist | LF00001277 | WA | Behavioral Health & Social Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| WA | WASHINGTON | 91-1453886 | 01 |
| Street Address |
11019 CANYON RD E |
| City | PUYALLUP |
| State | WA |
| Zip Code | 98373-3001 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1558366708 | Donna R Quiles | Radiologic Technologist | 11019 Canyon Rd E, Puyallup, WA 98373-3001 | 2005-06-15 |
| 1558737296 | Tessa Carson | Physical Therapist | 11019 Canyon Rd E, Ste C, Puyallup, WA 98373-3001 | 2015-08-17 |
| 1346642196 | Benjamin R. Cichon | Physician Assistant | 11019 Canyon Rd E, Ste A, Puyallup, WA 98373-3001 | 2014-09-24 |
| 1578813465 | Krissa Jo Orlowski | Physician Assistant | 11019 Canyon Rd E, Suite A, Puyallup, WA 98373-4298 | 2012-09-18 |
| 1558618314 | Danielle Marie Bergman | Occupational Therapist | 11019 Canyon Rd E, Ste C, Puyallup, WA 98373-3001 | 2012-08-11 |
| 1831405737 | Dlana Lea Joyner | Occupational Therapist | 11019 Canyon Rd E, Suite C, Puyallup, WA 98373-3001 | 2010-08-30 |
| 1518291178 | Eric David Duarte | Occupational Therapist | 11019 Canyon Rd E, Suite C, Puyallup, WA 98373-3001 | 2009-09-29 |
| 1043543598 | Amanda Christine King | Physical Therapist | 11019 Canyon Rd E, Suite C, Puyallup, WA 98373-3001 | 2009-09-16 |
| 1275678989 | Apple Physical Therapy Ps | Durable Medical Equipment & Medical Supplies | 11019 Canyon Rd E, Suite C, Puyallup, WA 98373-3001 | 2007-02-20 |
| 1437229721 | Mickie Hucke | Physical Therapist | 11019 Canyon Rd E, Suite C, Puyallup, WA 98373-3001 | 2006-11-08 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801494711 | Caroline Brown Corbett | Dentist | 8012 112th St Ct E #320, Puyallup, WA 98373 | 2020-10-13 |
| 1629615760 | Jessie Jean Waiamau-ariota | Counselor | Winds of Liberty, 702 S Hill Park Dr Ste 206, Puyallup, WA 98373 | 2019-12-09 |
| 1194369181 | Ruba H Tawil | Dentist | 12005 Meridian E # 102, Puyallup, WA 98373 | 2019-11-01 |
| 1336621267 | Cara Tseng | Physician Assistant | 2940 S Meridian, Suite 200, Puyallup, WA 98373 | 2018-09-06 |
| 1902390289 | Melissa M Jenkins | Registered Nurse | 2920 S Meridian Ste 100, Puyallup, WA 98373 | 2018-06-19 |
| 1881141323 | Linda Cole | Massage Therapist | 8409 204th Street East, Spanaway, WA 98373 | 2016-09-01 |
| 1861855389 | Christina Leigh Bailey | Optometrist | 3500 S Meridian Ste 926, Puyallup, WA 98373 | 2016-04-01 |
| 1518301951 | Bryan Michael Swanson | Dentist | 2910 S Meridian Ste 120, Puyallup, WA 98373 | 2013-04-27 |
| 1760720569 | Vankosin Hewitt | Massage Therapist | 13613 Meridian East # 260, Puyallup, WA 98373 | 2013-01-29 |
| 1558607705 | Rosie Martinez | Counselor | 12812 101st Avenue Courte E, Suite 202, Puyallup, WA 98373 | 2012-12-17 |
| Find all providers in zip 98373 | ||||
| Taxonomy Code | 101YM0800X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Mental Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437784584 | Steven William Wagner | Counselor | 12909 106th Avenue Ct E, Puyallup, WA 98374-3048 | 2020-03-10 |
| 1073147484 | Jackie Kerns St. Louis | Counselor | 8506 137th Street Ct E, Puyallup, WA 98373-6415 | 2020-02-24 |
| 1629615760 | Jessie Jean Waiamau-ariota | Counselor | Winds of Liberty, 702 S Hill Park Dr Ste 206, Puyallup, WA 98373 | 2019-12-09 |
| 1104486158 | Jodi Marie Youngquist | Counselor | 11102 Sunrise Blvd E Ste 100, Puyallup, WA 98374-8846 | 2019-06-20 |
| 1649839739 | Aathina Dillard | Counselor | 102 23rd Ave Se Unit 102a, Puyallup, WA 98372-4501 | 2019-06-11 |
| 1124599972 | Orenda Counseling, LLC | Counselor | 104 W. Meeker #f, Puyallup, WA 98371-8901 | 2018-12-05 |
| 1558877696 | Picket Fene Therapy & Consulting, LLC | Counselor | 105b W Main Ste 105, Puyallup, WA 98371-5329 | 2017-12-27 |
| 1831603851 | Minza Cheyo Kuyenga | Counselor | 14020 176th St E, Puyallup, WA 98374-9294 | 2017-11-29 |
| 1245759109 | Jaclyn Watson | Counselor | 417 E Pioneer Ste B, Puyallup, WA 98372-3267 | 2017-09-12 |
| 1609321603 | Kristina Nicole Durene | Counselor | 1420 S Meridian Ste C, Puyallup, WA 98371-6914 | 2016-08-19 |
| Find all providers in PUYALLUP | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.