MEDICARE: MARGARET SUSAN POWERS P.T.

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	PT00003730	WA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	P04519	OTHER	WA	REGENCE BLUE SHIELD
2	126385	OTHER	WA	DEPT OF LABOR & INDUSTRIE
3	4220746	OTHER	WA	AETNA/LEXINGTON, KY

General Provider Information

NPI Number	:	1871548081
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MARGARET SUSAN POWERS P.T.

Provider Business Mailing Address
First Line	:	3225 NE 125TH ST
Second Line	:
City	:	SEATTLE
State	:	WA
Zip	:	98125-4516
Country	:	US
Telephone Number	:	206-417-1298
Fax Number	:	206-417-1299

Provider Business Practice Location Address
First Line	:	3225 NE 125TH ST
Second Line	:
City	:	SEATTLE
State	:	WA
Zip	:	98125-4516
Country	:	US
Telephone Number	:	206-417-1298
Fax Number	:	206-417-1299

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

Provider Enumeration Date	:	05/24/2006
Last Update Date	:	02/04/2014

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