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General NPI Number Information
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NPI Number | 1306191101
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Entity Type | Individual
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Provider Name | ELIZABETH ELLEN ANSLEY DPT
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Gender | Female
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Dates
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Enumeration Date | 07/17/2012
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Last Update Date | 03/27/2014
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Provider Practice Location Address
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Address Line | 4060 WHEATON WAY STE. C
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City | BREMERTON
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State | WA
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Zip | 98310-3500
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Country | US
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Telephone | 360-479-8477
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Fax | 360-479-8417
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Provider Business Mailing Address
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Address Line | 4040 ORCHARD ST W STE. 100
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City | FIRCREST
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State | WA
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Zip | 98466-6606
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Country | US
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Telephone | 253-564-1560
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Fax | 253-564-4449
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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 | PT60313041
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License Number State | WA
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