Healthcare Provider Details

I. General information

NPI: 1629804885
Provider Name (Legal Business Name): ANGELICA R HULETT BSK, DPT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/12/2024
Last Update Date: 09/12/2024
Certification Date: 09/12/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

626 N MULLAN RD STE 4
SPOKANE VALLEY WA
99206-3857
US

IV. Provider business mailing address

626 N MULLAN RD STE 4
SPOKANE VALLEY WA
99206-3857
US

V. Phone/Fax

Practice location:
  • Phone: 509-892-5442
  • Fax: 509-892-5462
Mailing address:
  • Phone: 509-892-5442
  • Fax: 509-892-5462

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: