Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225100000X | Physical Therapist | PT60631933 | WA |
N | 2251N0400X | Physical Therapist - Neurology | 33001 | CA |
NPI | 1265806004 |
---|---|
Provider Name | Christina Dhesi-Bawa |
First Address | Olympia, WA 98506-5115 |
Second Address | Olympia, WA 98506-5115 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 17/11/2015 |
Last Update Date | 20/04/2021 |