Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225100000X | Physical Therapist | 00006115 | WA |
N | 2251G0304X | Physical Therapist - Geriatrics | 00006115 | WA |
N | 2251N0400X | Physical Therapist - Neurology | 00006115 | WA |
NPI | 1285664094 |
---|---|
Provider Name | Mr. Christopher Theron Morrow |
First Address | Seattle, WA 98109-0940 |
Second Address | Seattle, WA 98109-4650 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 04/07/2006 |
Last Update Date | 06/10/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
8855073 | MEDICARE ID PIN (01) | WA |