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General NPI Number Information
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NPI Number | 1275686297
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Entity Type | Organization
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Legal Business Name | WAVE THERAPIES PLLC
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Dates
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Enumeration Date | 01/21/2007
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Last Update Date | 08/05/2008
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Provider Practice Location Address
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Address Line | 7711 196TH AVE NE
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City | REDMOND
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State | WA
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Zip | 98053-4700
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Country | US
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Telephone | 206-782-5555
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Fax | 425-868-9922
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Provider Business Mailing Address
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Address Line | PO BOX 3432
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City | REDMOND
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State | WA
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Zip | 98073-3432
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Country | US
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Telephone | 206-782-5555
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Fax | 425-868-9922
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Authorized Official
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Title or Position | OWNER-THERAPIST
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Name | JENNIFER MARTYN
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Credential | PT
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Telephone | 206-782-5555
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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 |
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License Number State |
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