Healthcare Provider Details

I. General information

NPI: 1265788145
Provider Name (Legal Business Name): REBECCA JEAN MORGAN PT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/30/2012
Last Update Date: 07/30/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2904 4TH AVE NE SUITE 300
PUYALLUP WA
98372-7053
US

IV. Provider business mailing address

17650 140TH AVE SE SUITE B-07
RENTON WA
98058-6814
US

V. Phone/Fax

Practice location:
  • Phone: 253-840-2313
  • Fax: 253-840-6340
Mailing address:
  • Phone: 425-430-0070
  • Fax: 425-430-0710

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberPT60280846
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: