MEDICARE: ANGELICA R HULETT BSK, 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

General Provider Information

NPI Number	:	1629804885
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ANGELICA R HULETT BSK, DPT

Provider Business Mailing Address
First Line	:	6066 HIGHWAY 291
Second Line	:
City	:	NINE MILE FALLS
State	:	WA
Zip	:	99026-5008
Country	:	US
Telephone Number	:	509-465-5663
Fax Number	:	509-467-8663

Provider Business Practice Location Address
First Line	:	6066 HIGHWAY 291
Second Line	:
City	:	NINE MILE FALLS
State	:	WA
Zip	:	99026-5008
Country	:	US
Telephone Number	:	509-465-5663
Fax Number	:	509-467-8663

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

Provider Enumeration Date	:	09/12/2024
Last Update Date	:	06/03/2026

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