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NPI Code Detail

MEDICARE: EMMA DICKINSON

MEDICARE: EMMA DICKINSON
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 TherapistPT 60550911WA

General Provider Information

NPI Number : 1740641471
Entity Type Code : Individual
Provider Name (Legal Business Name) : EMMA DICKINSON
Provider Business Mailing Address
First Line : 25117 SW PARKWAY AVE
Second Line : STE D
City : WILSONVILLE
State : OR
Zip : 97070-9697
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 1630 43RD AVE E
Second Line :
City : SEATTLE
State : WA
Zip : 98112-6210
Country : US
Telephone Number : 206-720-8281
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/08/2016
Last Update Date : 03/08/2016

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Directions to “ EMMA DICKINSON ” Practice Location

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