MEDICARE: SUZANNE OLIVER 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	2251X0800X	Orthopedic Physical Therapist	PT00003177	WA

General Provider Information

NPI Number	:	1497795751
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SUZANNE OLIVER PT

Provider Business Mailing Address
First Line	:	PO BOX 77690
Second Line	:
City	:	SEATTLE
State	:	WA
Zip	:	98177-0690
Country	:	US
Telephone Number	:	206-310-3439
Fax Number	:	206-542-7466

Provider Business Practice Location Address
First Line	:	600 N 36TH ST STE 213
Second Line	:
City	:	SEATTLE
State	:	WA
Zip	:	98103-8697
Country	:	US
Telephone Number	:	206-310-3439
Fax Number	:	206-542-7466

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

Provider Enumeration Date	:	06/07/2006
Last Update Date	:	07/21/2022

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Directions to “ SUZANNE OLIVER PT” Practice Location

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