Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 225100000X | Physical Therapist | PT00002090 | WA |
Y | 2251P0200X | Physical Therapist - Pediatrics | PT00002090 | WA |
NPI | 1093889859 |
---|---|
Provider Name | Kathleen A. Washington |
First Address | Seattle, WA 98124-0366 |
Second Address | Seattle, WA 98195-0001 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 20/11/2006 |
Last Update Date | 12/10/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
U06087 | REGENCE BLUESHIELD (01) | WA |