Diana Jean Franckowiak, PTA

Primary specialty

Physical Therapy AssistantTaxonomy code 225200000X

License

60734738 Issued in WA

Practice address

901 Mountain View Dr
Shelton, WA 98584-4401

Phone

(360) 427-9545

NPI assigned

Sep 18, 2020

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1600387200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1600387200000",
    "number": "1891301560",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "901 MOUNTAIN VIEW DR",
            "city": "SHELTON",
            "state": "WA",
            "postal_code": "985844401",
            "telephone_number": "360-427-9545"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "901 MOUNTAIN VIEW DR",
            "city": "SHELTON",
            "state": "WA",
            "postal_code": "985844401",
            "telephone_number": "360-427-9545"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FRANCKOWIAK",
        "first_name": "DIANA",
        "middle_name": "JEAN",
        "credential": "PTA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-09-18",
        "last_updated": "2020-09-18",
        "certification_date": "2020-09-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "WA",
            "license": "60734738",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• FMG North 13TH Street Washington
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• Suzanna Louise Fuentes, LMP

• Physical Therapy Assistant in Shelton, WA
• Providers in Shelton, WA by specialty
• Physical Therapy Assistant in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 18, 2020; 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.