Debra Lynnette Bathurst, PHYSICAL THERAPIST A

Individual provider Active NPI Physical Therapy Assistant · Federal Way, WA

NPI 1720183379 · NPPES record last updated Jul 8, 2007

Key facts

NPI
1720183379
Entity type
Individual (NPI type 1)
Primary specialty
Physical Therapy Assistant 225200000X
License
014931 (FL)
Practice address
31919 1 St Ave S
Suite 101
Federal Way, WA 98003
Phone
(253) 874-3092
NPI assigned
Sep 14, 2006
Sex
Female
Sole proprietor
No

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
014931FLMDPhysical Therapy Assistant

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Assistant 225200000X 014931 FL Yes

Addresses

Primary practice location

31919 1 St Ave S
Suite 101
Federal Way, WA 98003

Mailing address

21907 39TH Place S
Kent, WA 98032
Phone (206) 715-7968

Other providers in Federal Way, WA

All providers in Federal Way, WA · Physical Therapy Assistant in Washington

Sources for this page

Verify at the official NPI Registry.