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General NPI Number Information
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NPI Number | 1528479862
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Entity Type | Organization
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Legal Business Name | HALLIE ALDRICH
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Dates
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Enumeration Date | 05/08/2014
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Last Update Date | 05/08/2014
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Provider Practice Location Address
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Address Line | 1818 WESTLAKE AVE N SUITE 330
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City | SEATTLE
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State | WA
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Zip | 98109
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Country | US
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Telephone | 415-577-3682
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Fax | 425-412-3281
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Provider Business Mailing Address
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Address Line | PO BOX 13492
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City | BURTON
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State | WA
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Zip | 98013
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Country | US
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Telephone | 415-577-3682
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Fax | 425-412-3281
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Authorized Official
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Title or Position | OWNER
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Name | MS. HALLIE E ALDRUCH
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Credential | LMP
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Telephone | 415-577-3686
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2000X
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Taxonomy Name | Physical Therapy Clinic/Center
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License Number | 60326058
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License Number State | WA
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