Individual
DIANE P ZELLEY
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
8011 112TH STREET CT E, PUYALLUP, WA 98373-7814
(253) 581-5200
(253) 581-5203
Mailing address
9315 GRAVELLY LAKE DR SW, SUITE 203, LAKEWOOD, WA 98499-1574
(253) 581-5200
(253) 581-5203
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
5022
CA
225100000X
Physical Therapist
Primary
PT00005637
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
31772
LABOR & INDUSTRIES
WA
05
—
8346934
—
WA
01
—
8930588
L&I CRIME VICTIMS PROGRAM
WA
01
—
ZE9838
REGENCE BLUESHIELD
WA
Enumeration date
06/08/2006
Last updated
07/08/2007
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