Individual
LAURA A IVERSON VON WULLERSTORFF
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
11800 NE 128TH STREET, SUITE 400, KIRKLAND, WA 98034-7208
(425) 820-0869
(425) 820-1745
Mailing address
1188 106TH AVE NE, SUITE 100, BELLEVUE, WA 98004-8614
(425) 454-4864
(425) 646-3901
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT00008484
WA
Other
Enumeration date
03/24/2006
Last updated
05/16/2012
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