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Organization
NORTHSIDE PHYSICAL THERAPY PS
Active
Organization
NORTHSIDE PHYSICAL THERAPY PS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. DEBORAH A PETERSON PT (OWNER PT)
(509) 325-6776
Entity
Organization
Contact information
Practice address
6821 N COUNTRY HOMES BLVD, SUITE 102, SPOKANE, WA 99208-4372
(509) 325-6776
(509) 325-0817
Mailing address
6821 N COUNTRY HOMES BLVD, SUITE 102, SPOKANE, WA 99208-4372
(509) 325-6776
(509) 325-0817
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0038860
L & I
—
05
—
7027386
—
WA
01
—
DA3797
RAILROAD MEDICARE
—
01
—
GAB37902
MEDICARE PROVIDER
—
Enumeration date
10/20/2006
Last updated
03/19/2008
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