Individual
HATTIE WALLACE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
1148 NW MARKET STREET, SUITE 200, SEATTLE, WA 98102
(206) 860-4461
Mailing address
1148 NW MARKET STREET, SUITE 200, SEATTLE, WA 98102
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
—
—
Other
Enumeration date
04/22/2022
Last updated
04/22/2022
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