Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225100000X | Physical Therapist | PT00002446 | WA |
NPI | 1003274986 |
---|---|
Provider Name | Zan Williams |
First Address | Shoreline, WA 98133-3718 |
Second Address | Shoreline, WA 98133-3718 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 05/02/2016 |
Last Update Date | 05/02/2016 |