Individual
CAITLYN LONG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DPT
Contact information
Practice address
201 TAHOMA BLVD, STE 207, YELM, WA 98597-7735
(360) 458-6400
(360) 458-6444
Mailing address
790 REMINGTON BLVD, BOLINGBROOK, IL 60440-4909
(630) 296-2223
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT 60419471
WA
225100000X
Physical Therapist
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0319980
DEPT. OF LABOR AND INDUSTRIES
WA
05
—
1083043459
—
WA
Enumeration date
11/06/2013
Last updated
07/13/2015
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