Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2251X0800X | Physical Therapist - Orthopedic | PT00006297 | WA |
N | 2251X0800X | Physical Therapist - Orthopedic | PT10903 | CA |
NPI | 1023090149 |
---|---|
Provider Name | Natalie Brenda Lew |
First Address | Everett, WA 98204-6335 |
Second Address | Everett, WA 98204-6335 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 15/11/2005 |
Last Update Date | 22/10/2007 |