Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2251X0800X | Physical Therapist - Orthopedic | 0011037 | CO |
NPI | 1003133232 |
---|---|
Provider Name | Nicole Siegel Bulow |
First Address | Seattle, WA 98118-2359 |
Second Address | Seattle, WA 98118-2359 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 28/04/2010 |
Last Update Date | 03/03/2021 |