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NPI Code Detail

MEDICARE: CARLEY RISSMAN

MEDICARE: CARLEY RISSMAN
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 Therapist

General Provider Information

NPI Number : 1467972091
Entity Type Code : Individual
Provider Name (Legal Business Name) : CARLEY RISSMAN
Provider Business Mailing Address
First Line : 1108 29TH AVE S APT B
Second Line :
City : SEATTLE
State : WA
Zip : 98144-3165
Country : US
Telephone Number : 360-941-4076
Fax Number :
Provider Business Practice Location Address
First Line : 4831 35TH AVE SW
Second Line :
City : SEATTLE
State : WA
Zip : 98126-2709
Country : US
Telephone Number : 206-937-3700
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/24/2017
Last Update Date : 06/24/2017

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Directions to “ CARLEY RISSMAN ” Practice Location

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