Healthcare Provider Details

I. General information

NPI: 1477434595
Provider Name (Legal Business Name): WELLSENIORS PT, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/08/2025
Last Update Date: 09/08/2025
Certification Date: 09/08/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

420 228TH ST SW APT B201
BOTHELL WA
98021-9781
US

IV. Provider business mailing address

420 228TH ST SW APT B201
BOTHELL WA
98021-9781
US

V. Phone/Fax

Practice location:
  • Phone: 425-471-1213
  • Fax:
Mailing address:
  • Phone: 425-471-1213
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QP2000X
TaxonomyPhysical Therapy Clinic/Center
License Number
License Number State

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name: DR. DAWNA SUE FUQUA-WHITLEY
Title or Position: OWNER AND PHYSICAL THERAPIST
Credential: PT, DPT
Phone: 425-471-1213