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General NPI Number Information
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NPI Number | 1770908915
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Entity Type | Individual
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Provider Name | LINDSEY DECREMER DPT
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Gender | Female
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Dates
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Enumeration Date | 02/25/2014
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Last Update Date | 08/26/2024
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Provider Practice Location Address
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Address Line | 5410 STADIUM LANE SE APT F101
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City | OLYMPIA
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State | WA
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Zip | 98501
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Country | US
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Telephone | 423-292-8413
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Fax |
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Provider Business Mailing Address
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Address Line | 12311 210TH ST E
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City | GRAHAM
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State | WA
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Zip | 98338-7751
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Country | US
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Telephone |
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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 | PT60435479
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License Number State | WA
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