Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225100000X | Physical Therapist | PT5528 | ME |
N | 2251G0304X | Physical Therapist - Geriatrics | 3813 | WA |
NPI | 1154489466 |
---|---|
Provider Name | Henrietta Pinkens |
First Address | Arlington, WA 98223-1511 |
Second Address | Arlington, WA 98223-1511 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 05/12/2006 |
Last Update Date | 12/12/2019 |