Individual
DINA PEGANOFF
Active
Individual
DINA PEGANOFF
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHYSICAL THERAPIST A
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
60695911
WA
225200000X
Physical Therapy Assistant
8260
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1518058031
—
WA
01
—
P01853434
RR MEDICARE
WA
Enumeration date
09/28/2006
Last updated
08/01/2017
Update your record
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