MEDICARE: SAMANTHA DELEHANT

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	225100000X	Physical Therapist	PT00009562	WA

General Provider Information

NPI Number	:	1568425130
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SAMANTHA DELEHANT

Provider Business Mailing Address
First Line	:	1188 106TH AVE NE
Second Line	:	SUITE 100
City	:	BELLEVUE
State	:	WA
Zip	:	98004-8614
Country	:	US
Telephone Number	:	425-454-4864
Fax Number	:	425-646-3901

Provider Business Practice Location Address
First Line	:	901 BOREN AVE
Second Line	:	SUITE 410
City	:	SEATTLE
State	:	WA
Zip	:	98104-3595
Country	:	US
Telephone Number	:	425-455-2630
Fax Number	:

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

Provider Enumeration Date	:	04/06/2006
Last Update Date	:	06/19/2008

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