MEDICARE: MAREN BISSON PT

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
1	225100000X	Physical Therapist	PT00008045	WA

General Provider Information

NPI Number	:	1154472686
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MAREN BISSON PT

Provider Business Mailing Address
First Line	:	3052 60TH AVE SW
Second Line	:
City	:	SEATTLE
State	:	WA
Zip	:	98116-2807
Country	:	US
Telephone Number	:	206-922-9230
Fax Number	:

Provider Business Practice Location Address
First Line	:	19820 SCRIBER LAKE RD
Second Line	:
City	:	LYNNWOOD
State	:	WA
Zip	:	98036-6121
Country	:	US
Telephone Number	:	425-673-5220
Fax Number	:	425-673-1597

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/12/2007
Last Update Date	:	07/08/2007

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Directions to “ MAREN BISSON PT” Practice Location

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