Individual
DR. GREGORY T WELLMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DPT
Contact information
Practice address
1027 REGENTS BLVD, FIRCREST, WA 98466-6030
(253) 720-5630
Mailing address
1027 REGENTS BLVD, FIRCREST, WA 98466-6030
(253) 720-5630
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT00009243
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1440WE
REGENCE BLUESHIELD
WA
01
—
174404
LABOR & INDUSTRIES
WA
05
—
8371098
—
WA
01
—
8930587
L&I CRIME VICTIMS PROGRAM
WA
Enumeration date
06/09/2006
Last updated
08/24/2010
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