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Individual
AMANDA D BALTAZAR
Active
Individual
AMANDA D BALTAZAR
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DPT
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
60989
OR
225100000X
Physical Therapist
Primary
PT60117609
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0259144
LABOR & INDUSTRIES
WA
01
—
60989
STATE
OR
Enumeration date
01/19/2010
Last updated
06/08/2015
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