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NPI Code Detail

MEDICARE: ELIZABETH ROSE BUTENKO DPT

MEDICARE: ELIZABETH ROSE BUTENKO 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 TherapistPT60161133WA

General Provider Information

NPI Number : 1518279108
Entity Type Code : Individual
Provider Name (Legal Business Name) : ELIZABETH ROSE BUTENKO DPT
Provider Business Mailing Address
First Line : PO BOX 2170
Second Line :
City : SUMNER
State : WA
Zip : 98390-0480
Country : US
Telephone Number : 253-840-2313
Fax Number : 253-840-6340
Provider Business Practice Location Address
First Line : 17650 140TH AVE SE
Second Line : #B-07
City : RENTON
State : WA
Zip : 98058-6814
Country : US
Telephone Number : 425-430-0700
Fax Number : 425-430-0710
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/12/2010
Last Update Date : 07/12/2010

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Directions to “ ELIZABETH ROSE BUTENKO DPT” Practice Location

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