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Organization
MINDFUL MOVEMENT PHYSICAL THERAPY, LLC
Active
Organization
MINDFUL MOVEMENT PHYSICAL THERAPY, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SUSAN MAZZAFERRO-KNOWLES (OWNER)
(206) 979-1413
Entity
Organization
Contact information
Practice address
3005 ALDERWOOD MALL PKWY, SUITE 100, LYNNWOOD, WA 98036-6920
(206) 979-1413
Mailing address
PO BOX 1570, MONROE, WA 98272-4570
(360) 799-6921
(360) 799-6922
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT00005338
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0313855
WA LABOR & INDUSTRIES
WA
Enumeration date
04/28/2013
Last updated
04/15/2020
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