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1790161586 NPI number — CAITLIN MARIE QUINN DPT

NPI Number: 1790161586
Health Care Provider/Practitioner: CAITLIN MARIE QUINN DPT

Information about “1790161586” NPI (CAITLIN MARIE QUINN DPT) exists in 1790161586 in HTML format HTML  |  1790161586 in plain Text format TXT  |  1790161586 in PDF (Portable Document Format) PDF  |  1790161586 in an XML format XML  formats.

NPI Number : 1790161586 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1790161586",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "N",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "QUINN",
    "FirstName": "CAITLIN",
    "MiddleName": "MARIE",
    "NamePrefix": null,
    "NameSuffix": null,
    "Credential": "DPT",
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": "CROSS",
    "OtherFirstName": "CAITLIN",
    "OtherMiddleName": "MARIE",
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": "1",
    "FirstLineMailingAddress": "510 8TH AVE NE STE 340",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "ISSAQUAH",
    "MailingAddressStateName": "WA",
    "MailingAddressPostalCode": "98029-5449",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "425-313-3055",
    "MailingAddressFaxNumber": "425-313-3051",
    "FirstLinePracticeLocationAddress": "510 8TH AVE NE STE 340",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "ISSAQUAH",
    "PracticeLocationAddressStateName": "WA",
    "PracticeLocationAddressPostalCode": "98029",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "425-313-3055",
    "PracticeLocationAddressFaxNumber": "425-313-3051",
    "EnumerationDate": "08/04/2015",
    "LastUpdateDate": "06/05/2018",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": "F",
    "Gender": "Female",
    "AuthorizedOfficialLastName": null,
    "AuthorizedOfficialFirstName": null,
    "AuthorizedOfficialMiddleName": null,
    "AuthorizedOfficialTitle": null,
    "AuthorizedOfficialNamePrefix": null,
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": null,
    "AuthorizedOfficialTelephoneNumber": null,
    "Taxonomies": {
      "Taxonomy": {
        "TaxonomyCode": "225100000X",
        "TaxonomyName": "Physical Therapist",
        "LicenseNumber": "PT60565741",
        "LicenseNumberStateCode": "WA",
        "PrimaryTaxonomySwitch": "Y"
      }
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

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