Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225200000X | Physical Therapy Assistant | P1 600688468 | WA |
NPI | 1013151950 |
---|---|
Provider Name | Kristin Nass |
First Address | Auburn, WA 98002-6822 |
Second Address | Auburn, WA 98002-6822 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 22/04/2009 |
Last Update Date | 22/04/2009 |