Healthcare Provider Details

I. General information

NPI: 1912882820
Provider Name (Legal Business Name): CLAIRE IWATA DPT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

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

III. Provider practice location address

31653 PACIFIC HWY S STE B
FEDERAL WAY WA
98003-5496
US

IV. Provider business mailing address

6050 TACOMA MALL BLVD STE 300
TACOMA WA
98409-6828
US

V. Phone/Fax

Practice location:
  • Phone: 253-252-7137
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberPT61667797
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: