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General NPI Number Information
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NPI Number | 1285748798
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Entity Type | Individual
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Provider Name | PAULA MARIE STILES P.T.
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Gender | Female
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Dates
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Enumeration Date | 08/19/2006
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Last Update Date | 05/15/2020
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Provider Practice Location Address
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Address Line | 23403 E MISSION AVE STE 100A
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City | LIBERTY LAKE
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State | WA
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Zip | 99019-7601
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Country | US
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Telephone | 509-990-4583
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Fax |
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Provider Business Mailing Address
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Address Line | 21675 E MILL RIVER LN
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City | LIBERTY LAKE
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State | WA
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Zip | 99019-7696
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Country | US
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Telephone | 509-990-4583
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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 | PT1678
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License Number State | ID
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Taxonomy #2
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | PT00008225
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License Number State | WA
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