MEDICARE: DR. ANNE SHUMWAY-COOK PT, PHD

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	PT00001060	WA

General Provider Information

NPI Number	:	1235258575
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ANNE SHUMWAY-COOK PT, PHD

Provider Business Mailing Address
First Line	:	3704 NE 165TH ST
Second Line	:
City	:	LAKE FOREST PARK
State	:	WA
Zip	:	98155-5419
Country	:	US
Telephone Number	:	106-364-5354
Fax Number	:

Provider Business Practice Location Address
First Line	:	3704 NE 165TH ST
Second Line	:
City	:	LAKE FOREST PARK
State	:	WA
Zip	:	98155-5419
Country	:	US
Telephone Number	:	106-364-5354
Fax Number	:

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

Provider Enumeration Date	:	03/28/2007
Last Update Date	:	07/08/2007

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