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General NPI Number Information
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NPI Number | 1174087233
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Entity Type | Individual
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Provider Name | ELIZABETH ALISE MCADIE PT, DPT
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Gender | Female
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Dates
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Enumeration Date | 01/23/2019
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Last Update Date | 12/14/2023
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Provider Practice Location Address
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Address Line | 6825 BURDEN BLVD STE D
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City | PASCO
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State | WA
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Zip | 99301-5633
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Country | US
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Telephone | 509-545-1010
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Fax |
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Provider Business Mailing Address
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Address Line | 5609 W 31ST AVE
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City | KENNEWICK
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State | WA
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Zip | 99338-2143
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Country | US
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Telephone | 262-501-8133
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | PT60926952
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License Number State | WA
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