Healthcare Provider Details

I. General information

NPI: 1295805737
Provider Name (Legal Business Name): MT. STUART P.T., P.S.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/09/2006
Last Update Date: 12/26/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10171A CHUMSTICK HWY
LEAVENWORTH WA
98826-8762
US

IV. Provider business mailing address

10171A CHUMSTICK HWY
LEAVENWORTH WA
98826-8762
US

V. Phone/Fax

Practice location:
  • Phone: 509-548-3133
  • Fax: 509-548-5356
Mailing address:
  • Phone: 509-548-3133
  • Fax: 509-548-5356

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: MS. CLAUDIA ANN CARANI
Title or Position: OFFICE MANAGER
Credential:
Phone: 509-548-3133