Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 225100000X | Physical Therapist | 11266 | CA |
Y | 225100000X | Physical Therapist | PT00005755 | WA |
N | 2251N0400X | Physical Therapist - Neurology | PT00005755 | WA |
NPI | 1730209248 |
---|---|
Provider Name | Lisa Barton Diller |
First Address | Kirkland, WA 98033-5211 |
Second Address | Kirkland, WA 98033-5211 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 29/03/2007 |
Last Update Date | 06/01/2022 |