Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 225200000X | Physical Therapy Assistant | 09683 | OR |
Y | 225200000X | Physical Therapy Assistant | 333 | HI |
N | 225200000X | Physical Therapy Assistant | 4803 | ID |
N | 225200000X | Physical Therapy Assistant | 60839352 | WA |
NPI | 1003473182 |
---|---|
Provider Name | Elisabeth Thatcher |
First Address | Kailua Kona, HI 96740-8118 |
Second Address | Bend, OR 97702-3558 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 23/05/2019 |
Last Update Date | 23/05/2019 |