Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225100000X | Physical Therapist | PT60106889 | WA |
NPI | 1003049982 |
---|---|
Provider Name | Amelia V. Rivera |
First Address | Seattle, WA 98104-2420 |
Second Address | Seattle, WA 98104-2420 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 26/08/2009 |
Last Update Date | 22/05/2013 |