Individual
MRS. TANIA EVELYN PETERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
909 MERIDIAN ST S, PUYALLUP, WA 98371-6908
(253) 845-6631
Mailing address
909 MERIDIAN ST S, PUYALLUP, WA 98371-6908
(253) 845-6631
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
P160033455
WA
Other
Enumeration date
05/06/2009
Last updated
05/06/2009
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