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General NPI Number Information
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NPI Number | 1760789747
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Entity Type | Individual
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Provider Name | SUZANN LORENE OAKES PT
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Gender | Female
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Dates
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Enumeration Date | 02/28/2011
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Last Update Date | 02/28/2011
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Provider Practice Location Address
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Address Line | 20420 MARINE DR.
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City | STANWOOD
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State | WA
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Zip | 98292
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Country | US
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Telephone | 360-652-7585
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Fax | 360-652-4594
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Provider Business Mailing Address
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Address Line | 4560 SE INTERNATIONAL WAY STE. 100
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City | MILWAUKIE
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State | OR
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Zip | 97222
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Country | US
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Telephone | 971-206-5200
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Fax | 971-206-5203
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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 | PT00002013
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License Number State | WA
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