Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 225100000X | Physical Therapist | PT5393 | ID |
Y | 2251H1200X | Hand | PT00007854 | WA |
NPI | 1194768325 |
---|---|
Provider Name | Dr. Sean S Sipe |
First Address | Tumwater, WA 98501-6523 |
Second Address | Lacey, WA 98503-5603 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/06/2006 |
Last Update Date | 14/10/2020 |