Individual
HOLLY C TANNER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MA, PT
Contact information
Practice address
3417 EVANSTON AVE N, SUITE 229, SEATTLE, WA 98103-8626
(206) 858-2914
(206) 732-6544
Mailing address
3417 EVANSTON AVE N, SUITE 229, SEATTLE, WA 98103-8626
(206) 858-2914
(206) 732-6544
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
5549
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
133463
DEPT OF LABOR & INDUSTRIE
WA
01
—
650017399
RAILROAD MEDICARE
WA
05
—
8332678
—
WA
01
—
8924971
CRIME VICTIMS
WA
01
—
A006
TRICARE
WA
01
—
TA8702
REGENCE BLUE SHIELD
WA
Enumeration date
08/15/2006
Last updated
09/02/2015
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