Organization
LAKELAND SPORTS & SPINE PHYSICAL THERAPY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PAMELA LOUISE WALKER (OFFICE MANAGER)
(253) 939-7179
Entity
Organization
Contact information
Practice address
1408 LAKE TAPPS PKWY E, SUITE E106, AUBURN, WA 98092-8158
(253) 939-7179
(253) 939-7182
Mailing address
1408 LAKE TAPPS PKWY E, SUITE E106, AUBURN, WA 98092-8158
(253) 939-7179
(253) 939-7182
Taxonomy
Speciality
Code
Description
License number
State
261QP2000X
Physical Therapy Clinic/Center
Primary
—
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1B 5711LA
REGENCE
WA
01
—
610775100
USDOL
—
01
—
G2 176891
L&I
WA
Enumeration date
03/12/2007
Last updated
07/21/2022
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