Marsha Lynn Dougherty, MS, PT

Primary specialty

Geriatric Physical TherapistTaxonomy code 2251G0304X

License

PT00010578 Issued in WA

Practice address

2430 N 13TH St
Shelton, WA 98584-1213

Phone

(360) 426-1651

NPI assigned

Feb 23, 2009

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1235347200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1235347200000",
    "number": "1760622286",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2033 EXCELSIOR DR SE",
            "city": "OLYMPIA",
            "state": "WA",
            "postal_code": "985013775",
            "telephone_number": "360-464-7459"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2430 N 13TH ST",
            "city": "SHELTON",
            "state": "WA",
            "postal_code": "985841213",
            "telephone_number": "360-426-1651"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DOUGHERTY",
        "first_name": "MARSHA",
        "middle_name": "LYNN",
        "name_prefix": "Ms.",
        "credential": "MS, PT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-02-23",
        "last_updated": "2009-02-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2251G0304X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Geriatrics",
            "state": "WA",
            "license": "PT00010578",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DEPARTMENT OF HEALTH",
            "identifier": "PT00010578",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Scott Michael Dickinson, SUDP
• Kristen Marie Distler
• Laura Dixon
• Donald R. Miller, MD
• Brenda Dorsey, MSW, LMHC
• Thomas Vincent Phung Duffy
• Dacia Aloha Dunbar
• Deborah Renee Duncan-Sargent, LMP
• Cynthia Jean Dyrnes, LMHC
• Clayton Eaton

• Geriatric Physical Therapist in Shelton, WA
• Providers in Shelton, WA by specialty
• Geriatric Physical Therapist in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 23, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.