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General NPI Number Information
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NPI Number | 1508159492
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Entity Type | Individual
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Provider Name | COURTNEY BENNETT D.P.T.
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Gender | Female
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Dates
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Enumeration Date | 05/25/2011
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Last Update Date | 08/15/2023
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Provider Practice Location Address
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Address Line | 9514 4TH ST NE
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City | LAKE STEVENS
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State | WA
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Zip | 98258-1937
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Country | US
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Telephone | 206-641-1335
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Fax |
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Provider Business Mailing Address
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Address Line | 8558 NESBIT AVE N UNIT 202
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City | SEATTLE
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State | WA
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Zip | 98103-4160
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Country | US
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Telephone | 206-641-1335
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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 | 38537
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License Number State | CA
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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 | 004661
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License Number State | IA
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Taxonomy #3
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | PT60297404
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License Number State | WA
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Taxonomy #4
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 12372-24
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License Number State | WI
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Taxonomy #5
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 1201110
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License Number State | TX
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