Ruth Ellen Allen, COTA

Individual provider Active NPI Physical Therapy Clinic/Center · Enumclaw, WA

NPI 1366700403 · NPPES record last updated Apr 26, 2012

Key facts

NPI
1366700403
Entity type
Individual (NPI type 1)
Primary specialty
Physical Therapy Clinic/Center 261QP2000X
License
OC 60231228 (WA)
Practice address
2323 Jensen St
Enumclaw, WA 98022-3605
Phone
(360) 825-2541
NPI assigned
Apr 26, 2012
Sex
Female
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
OC 60231228WAMDPhysical Therapy Clinic/Center

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Clinic/Center 261QP2000X OC 60231228 WA Yes

Addresses

Primary practice location

2323 Jensen St
Enumclaw, WA 98022-3605

Mailing address

720 209TH Avenue CT E
Lake Tapps, WA 98391-5602
Phone (253) 862-4795

Other providers in Enumclaw, WA

All providers in Enumclaw, WA · Physical Therapy Clinic/Center in Washington

Sources for this page

Verify at the official NPI Registry.