Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225100000X | Physical Therapist | PT60247651 | WA |
N | 2251N0400X | Physical Therapist - Neurology | PT60247651 | WA |
N | 2251P0200X | Physical Therapist - Pediatrics | PT60247651 | WA |
NPI | 1013294552 |
---|---|
Provider Name | Ms. Hannah L Goldstein |
First Address | Olympia, WA 98502-2704 |
Second Address | Tacoma, WA 98409-2314 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 11/11/2011 |
Last Update Date | 11/11/2011 |