Individual
LISA M KRASOWSKI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
9575 ETHAN WADE WAY SE, SNOQUALMIE, WA 98065-9577
(425) 831-2376
Mailing address
9575 ETHAN WADE WAY SE, SNOQUALMIE, WA 98065-9577
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
P160033900
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
P160033900
HEALTHCARE PROVIDER LICENSE
WA
Enumeration date
04/30/2013
Last updated
04/30/2013
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