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General NPI Number Information
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NPI Number | 1669685913
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Entity Type | Organization
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Legal Business Name | VASHON PHYSICAL THERAPY
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Dates
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Enumeration Date | 05/07/2007
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Last Update Date | 12/11/2007
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Provider Practice Location Address
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Address Line | 17429 VASHON HWY. SW
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City | VASHON
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State | WA
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Zip | 98070
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Country | US
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Telephone | 206-463-3441
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Fax | 206-463-3089
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Provider Business Mailing Address
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Address Line | PO BOX 2189
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City | VASHON
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State | WA
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Zip | 98070-2189
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Country | US
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Telephone | 206-463-3441
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Fax | 206-463-3089
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Authorized Official
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Title or Position | SOLEPROPRIETER
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Name | MS. MARILYN NELL KLEYN
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Credential | PT
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Telephone | 206-463-3441
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | PT00001022
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License Number State | WA
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