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NPI Code Detail

MEDICARE: MS. NATASHA A MACILVEEN PT, DPT

MEDICARE: MS. NATASHA A MACILVEEN PT, DPT
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 Therapist33938CA
2225100000XPhysical Therapist5419OR
3225100000XPhysical TherapistPT60392875WA

General Provider Information

NPI Number : 1316129760
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. NATASHA A MACILVEEN PT, DPT
Provider Business Mailing Address
First Line : PO BOX 851
Second Line :
City : TWISP
State : WA
Zip : 98856-0851
Country : US
Telephone Number : 503-281-5947
Fax Number :
Provider Business Practice Location Address
First Line : 202 WHITE AVE
Second Line :
City : WINTHROP
State : WA
Zip : 98862-9774
Country : US
Telephone Number : 509-996-8234
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/28/2007
Last Update Date : 08/27/2013

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