Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2251P0200X | Physical Therapist - Pediatrics | PT00008814 | WA |
NPI | 1013215383 |
---|---|
Provider Name | Debra Beth Glazer |
First Address | Seattle, WA 98115-7830 |
Second Address | Seattle, WA 98105-4107 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 10/03/2011 |
Last Update Date | 10/03/2011 |