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Individual

LESLIE ANN PRUITT

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
DPT

Contact information

Practice address
909 UNIVERSITY ST, 217, SEATTLE, WA 98101-2772
(206) 341-1131
Mailing address
17624 133RD PL SE, RENTON, WA 98058-6839
(206) 356-3548

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT60209140
WA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0277791
DEPT OF LABOR & INDUSTRIES
WA
05
1245538024
WA
Enumeration date
03/03/2011
Last updated
05/10/2011
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