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NPI Code Detail

MEDICARE: MRS. ELIZABETH P HENRY PT

MEDICARE: MRS. ELIZABETH P HENRY PT
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1225100000XPhysical TherapistPT00002037WA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1HE5230OTHERWAREGENCE PROVIDER NUMBER
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1225122831
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. ELIZABETH P HENRY PT
Provider Business Mailing Address
First Line : 2520 7TH STREET S.E.
Second Line :
City : PUYALLUP
State : WA
Zip : 98374-1105
Country : US
Telephone Number : 253-848-2309
Fax Number : 253-848-8407
Provider Business Practice Location Address
First Line : 2520 7TH STREET S.E.
Second Line :
City : PUYALLUP
State : WA
Zip : 98374-1105
Country : US
Telephone Number : 253-848-2309
Fax Number : 253-848-8407
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/03/2006
Last Update Date : 10/18/2007

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Directions to “ MRS. ELIZABETH P HENRY PT” Practice Location

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