Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2251P0200X | Physical Therapist - Pediatrics | PT00003594 | WA |
NPI | 1003393257 |
---|---|
Provider Name | Laura Reed |
First Address | Yakima, WA 98902 |
Second Address | Yakima, WA 98902 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 20/07/2018 |
Last Update Date | 20/07/2018 |