Wendy M Fogelson, PTA
Individual provider Active NPI Physical Therapy Assistant · Chelan, WA
NPI 1245796135 · NPPES record last updated Feb 15, 2019
Key facts
- NPI
- 1245796135
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physical Therapy Assistant 225200000X
- License
- P10038766 (WA)
- Practice address
- 123 E Johnson Ave
Suite 4
Chelan, WA 98816 - Phone
- (509) 682-4713
- Fax
- (509) 682-3218
- NPI assigned
- Feb 15, 2019
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 2
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| P10038766 | WA | MD | Physical Therapy Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Lake Chelan Physical Therapy, PS | Past | Accepting new patients | |
| Lake Chelan Physical Therapy, PS | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapy Assistant | 225200000X | P10038766 | WA | Yes |
Addresses
Primary practice location
123 E Johnson Ave
Suite 4
Chelan, WA 98816
Mailing address
PO Box 6
Chelan, WA 98816-0006
Phone (509) 682-4713
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| P10038766 | Other | WA | STATE LICENSE |
Other providers in Chelan, WA
- Deandra M England
- Rick Lee Fesler
- Anna Therese Fleming
- Brenda Kay Fleshman
- Charles Eric Flynn
- Kai Valdemar Folke
- Krista Sue Frahm
- Catherine Freeman
- Brandon Fromm
- Nahuma M Galindo
All providers in Chelan, WA · Physical Therapy Assistant in Washington
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 15, 2019. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.