Individual
SEKER MEDAVARAPU
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PT
Contact information
Practice address
450 THAIN RD STE A, LEWISTON, ID 83501-5300
(208) 816-8836
(208) 621-2995
Mailing address
450 THAIN RD STE A, LEWISTON, ID 83501-5300
(208) 816-8836
(208) 621-2995
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT00007804
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0210111
LABOR & INDUSTRIES
WA
05
—
8366544
—
WA
Enumeration date
12/14/2006
Last updated
11/29/2023
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