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NPI Code Detail

MEDICARE: TARA E SOCQUET PT

MEDICARE: TARA E SOCQUET 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
1225100000XPhysical TherapistPT60025787WA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1PT60025787OTHERWAPT LICENSE

General Provider Information

NPI Number : 1457408098
Entity Type Code : Individual
Provider Name (Legal Business Name) : TARA E SOCQUET PT
Provider Business Mailing Address
First Line : 2515 NW 47TH AVE
Second Line :
City : CAMAS
State : WA
Zip : 98607-8314
Country : US
Telephone Number : 650-814-9868
Fax Number :
Provider Business Practice Location Address
First Line : 8716 E MILL PLAIN BLVD
Second Line :
City : VANCOUVER
State : WA
Zip : 98664-2531
Country : US
Telephone Number : 360-696-5300
Fax Number : 360-729-3372
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/05/2007
Last Update Date : 04/15/2024

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Directions to “ TARA E SOCQUET PT” Practice Location

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