Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225100000X | Physical Therapist | PT00003958 | WA |
N | 226300000X | Kinesiotherapist | PT00003958 | WA |
NPI | 1982152419 |
---|---|
Provider Name | Shiri K. Krasner-Rosenstein |
First Address | Edmonds, WA 98026-8006 |
Second Address | Mill Creek, WA 98012-1500 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 13/09/2016 |
Last Update Date | 10/02/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
2070204 | (05) | WA |
366390 | WA LABOR & INDUSTRIES (01) | WA |