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General NPI Number Information
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NPI Number | 1952986184
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Entity Type | Organization
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Legal Business Name | PHYSIOWORKS SILVERDALE PLLC
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Dates
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Enumeration Date | 03/09/2021
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Last Update Date | 03/09/2021
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Provider Practice Location Address
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Address Line | 9399 RIDGETOP BLVD NW STE 102
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City | SILVERDALE
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State | WA
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Zip | 98383-8580
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Country | US
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Telephone | 360-900-2626
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Fax |
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Provider Business Mailing Address
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Address Line | 17526 163RD PL SE
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City | RENTON
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State | WA
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Zip | 98058-9131
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Country | US
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Telephone | 425-879-3403
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Fax |
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Authorized Official
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Title or Position | ADMINISTRATIVE DIRECTOR
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Name | NANCY LYNN RICKERSON
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Credential | PH.D, OTR/L
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Telephone | 425-879-3403
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QR0400X
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Taxonomy Name | Rehabilitation Clinic/Center
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License Number |
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License Number State |
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