Malia Winona Dettori, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

PT60186839 Issued in WA

Practice address

2560 32ND Ave W
Seattle, WA 98199-3220

Phone

(206) 660-1218

Fax

(206) 494-7676

NPI assigned

Oct 22, 2010

Last updated

Dec 15, 2016By the provider in NPPES

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

Other names 1

• Malia Winona Anderson Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Alpine Physical Therapy PLLC

  • Physical Therapist
  • Seattle, WA
  • NPI 1134576291
  NPD (past)
• Highline Physical Therapy Group

  dba Highline Physical Therapy

  • Multi-Specialty Clinic/Center
  • Burien, WA
  • NPI 1093876898

  Physical Therapist

  NPD (past)
• Highline Physical Therapy Group

  dba Highline Therapy Services

  • Physical Therapist
  • Burien, WA
  • NPI 1477797991
  NPD (past)

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

{
    "created_epoch": "1287705600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1481760000000",
    "number": "1922308063",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 99483",
            "address_2": "SUITE 104",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981390483",
            "telephone_number": "206-660-1218",
            "fax_number": "206-494-7676"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2560 32ND AVE W",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981993220",
            "telephone_number": "206-660-1218",
            "fax_number": "206-494-7676"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DETTORI",
        "first_name": "MALIA",
        "middle_name": "WINONA",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-10-22",
        "last_updated": "2016-12-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "WA",
            "license": "PT60186839",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MALIA",
            "last_name": "ANDERSON",
            "middle_name": "WINONA",
            "credential": "DPT",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Ariell Rose Desure, MD
• Stella Desyatnikova, M.D.
• Barbara J. Detering, M.D.
• Ann R. Determan, RC
• Jana Kathleen Detrick, MA
• Susan E Detweiler, MD
• Dana Wolak Detwiler
• Daryl Jay Detwiler, DDS
• Elaine Esther Detwiler, RN
• Mark Detwiler, R.N.

• Physical Therapist in Seattle, WA
• Providers in Seattle, WA by specialty
• Physical Therapist in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 15, 2016; 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.