Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2251P0200X | Physical Therapist - Pediatrics | PT00005303 | WA |
NPI | 1124440342 |
---|---|
Provider Name | Ann Cowan |
First Address | Olympia, WA 98506-5133 |
Second Address | Olympia, WA 98506-5133 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 07/01/2014 |
Last Update Date | 07/01/2014 |