MEDICARE: ANALEE EDLEFSEN DPT

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
1	225100000X	Physical Therapist	6032	OR
2	225100000X	Physical Therapist	PT60427782	WA
3	225100000X	Physical Therapist	06032	OR

General Provider Information

NPI Number	:	1225268493
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ANALEE EDLEFSEN DPT

Provider Business Mailing Address
First Line	:	21009 76TH AVE W
Second Line	:	AXIS PHYSICAL THERAPY INC
City	:	EDMONDS
State	:	WA
Zip	:	98026-7126
Country	:	US
Telephone Number	:	425-672-2910
Fax Number	:	425-778-1872

Provider Business Practice Location Address
First Line	:	21009 76TH AVE W
Second Line	:	AXIS PHYSICAL THERAPY INC
City	:	EDMONDS
State	:	WA
Zip	:	98026-7126
Country	:	US
Telephone Number	:	425-672-2910
Fax Number	:	425-778-1872

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/21/2009
Last Update Date	:	02/10/2014

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Directions to “ ANALEE EDLEFSEN DPT” Practice Location

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