Healthcare Provider Details

I. General information

NPI: 1831515030
Provider Name (Legal Business Name): CYNTHIA MURRAY
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/12/2014
Last Update Date: 03/12/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

34921 US HIGHWAY 19 N SUITE 450
PALM HARBOR FL
34684-1969
US

IV. Provider business mailing address

5219 58TH AVE SE
OLYMPIA WA
98513-5085
US

V. Phone/Fax

Practice location:
  • Phone: 800-251-8998
  • Fax:
Mailing address:
  • Phone: 360-791-1637
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225200000X
TaxonomyPhysical Therapy Assistant
License Number23354
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code225200000X
TaxonomyPhysical Therapy Assistant
License Number6276
License Number StateCA
# 3
Primary TaxonomyN
Taxonomy Code225200000X
TaxonomyPhysical Therapy Assistant
License NumberP160113654
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: