Active NPI
Abby Lauren Wisniewski, PT, DPT
- Physical Therapist
- Camas, WA
National Provider Identifier
1255879441
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 60717255
- Practice address
- 740 NE Dallas St
Camas, WA 98607-2058 - Phone
- (360) 834-5055
- NPI assigned
- Feb 7, 2017
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 60717255 | WA | Primary |
| Physical Therapist | 225100000X | 3774 | AR |
Addresses
Primary practice location
740 NE Dallas St
Camas, WA 98607-2058
Mailing address
740 NE Dallas Street
Camas, WA 98607-2058
Phone (360) 834-5055
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 3774 | AR | MD | General Practice Dentistry |
| 60717255 | WA | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1486425600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1486425600000",
"number": "1255879441",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "740 NE DALLAS STREET",
"city": "CAMAS",
"state": "WA",
"postal_code": "986072058",
"telephone_number": "360-834-5055"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "740 NE DALLAS ST",
"city": "CAMAS",
"state": "WA",
"postal_code": "986072058",
"telephone_number": "360-834-5055"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WISNIEWSKI",
"first_name": "ABBY",
"middle_name": "LAUREN",
"name_prefix": "Dr.",
"credential": "PT, DPT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2017-02-07",
"last_updated": "2017-02-07",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "WA",
"license": "60717255",
"primary": true
},
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "AR",
"license": "3774",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Camas, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 7, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.