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Individual

MRS. NANCY GARDNER

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
PTA

Contact information

Practice address
17201 15TH AVE NE, SHORELINE, WA 98155-5129
(206) 364-9336
Mailing address
28007 NE AMES LAKE RD, REDMOND, WA 98053-9149
(425) 736-5069

Taxonomy

Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
P160174433
WA

Other

Enumeration date
01/27/2014
Last updated
01/27/2014
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