Healthcare Provider Details

I. General information

NPI: 1013294552
Provider Name (Legal Business Name): HANNAH L GOLDSTEIN DPT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/11/2011
Last Update Date: 11/11/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5006 CENTER ST STE N
TACOMA WA
98409-2314
US

IV. Provider business mailing address

3000 LIMITED LN NW STE 100
OLYMPIA WA
98502-2704
US

V. Phone/Fax

Practice location:
  • Phone: 253-476-0449
  • Fax:
Mailing address:
  • Phone: 360-292-7245
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberPT60247651
License Number StateWA
# 2
Primary TaxonomyN
Taxonomy Code2251N0400X
TaxonomyNeurology Physical Therapist
License NumberPT60247651
License Number StateWA
# 3
Primary TaxonomyN
Taxonomy Code2251P0200X
TaxonomyPediatric Physical Therapist
License NumberPT60247651
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: