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NPI Code Detail

MEDICARE: SIGNIA A RAY P.T.

MEDICARE: SIGNIA A RAY P.T.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1225100000XPhysical TherapistPT00002101WA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
159041OTHERWASTATE OF WA WORKERS COMP
2RA2554OTHERWAREGENCE BLUE SHIELD RIDER
3MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1154305167
Entity Type Code : Individual
Provider Name (Legal Business Name) : SIGNIA A RAY P.T.
Provider Business Mailing Address
First Line : 201 160TH ST S
Second Line : SUITE 301
City : SPANAWAY
State : WA
Zip : 98387-8508
Country : US
Telephone Number : 253-531-4100
Fax Number : 253-531-3795
Provider Business Practice Location Address
First Line : 201 160TH ST S
Second Line : SUITE 301
City : SPANAWAY
State : WA
Zip : 98387-8508
Country : US
Telephone Number : 253-531-4100
Fax Number : 253-531-3795
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/02/2005
Last Update Date : 08/10/2010

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Directions to “ SIGNIA A RAY P.T.” Practice Location

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