Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225100000X | Physical Therapist | PT00009784 | WA |
N | 2251S0007X | Physical Therapist - Sports | PT00009784 | WA |
NPI | 1346222932 |
---|---|
Provider Name | Julie A Vanni |
First Address | Seattle, WA 98116-4303 |
Second Address | Seattle, WA 98116-4303 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 18/11/2005 |
Last Update Date | 30/12/2015 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0198452 | LABOR & INDUSTRIES (01) | WA |
11481575 | CAQH (01) |