Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2251P0200X | Physical Therapist - Pediatrics | PT00002513 | WA |
NPI | 1003023847 |
---|---|
Provider Name | Beth Simon Crabtree |
First Address | Tacoma, WA 98403-2914 |
Second Address | Issaquah, WA 98027-2717 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 17/05/2007 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
8344855 | (05) | WA |