Individual
SAMANTHA PREVOT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
27005 PACIFIC HWY S, DES MOINES, WA 98198-9250
(253) 839-9280
Mailing address
3323 90TH ST S, LAKEWOOD, WA 98499-9111
(253) 831-5648
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
P1 60468295
WA
Other
Enumeration date
01/28/2015
Last updated
01/28/2015
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