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General NPI Number Information
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NPI Number | 1407283054
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Entity Type | Individual
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Provider Name | CHRISTY LYNN ENGRACIA PT
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Gender | Female
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Dates
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Enumeration Date | 09/27/2013
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Last Update Date | 12/08/2021
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Provider Practice Location Address
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Address Line | 24121 116TH AVE SE
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City | KENT
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State | WA
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Zip | 98030-5379
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Country | US
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Telephone | 253-856-1600
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Fax |
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Provider Business Mailing Address
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Address Line | 3032 16TH ST SE
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City | AUBURN
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State | WA
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Zip | 98092-6462
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Country | US
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Telephone | 928-846-9214
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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 | 10227
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License Number State | AZ
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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 | 60572607
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License Number State | WA
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