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Individual
MICHAEL ROBERT SEVERINO
Active
Individual
MICHAEL ROBERT SEVERINO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
B.S., P.T.
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
CP001164T
AZ
225100000X
Physical Therapist
PT00009969
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0204468
LABOR & INDUSTRIES
WA
05
—
8442717
—
WA
Enumeration date
03/21/2006
Last updated
03/16/2020
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