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Organization

LAKE FOREST PARK PHYSICAL THERAPY, PLLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MRS. ROBYN NAMIKO WHITEHEAD LPTA (EXECUTIVE DIRECTOR)
(206) 979-8248
Entity
Organization

Contact information

Practice address
20011 BALLINGER WAY NE, STE C100, SHORELINE, WA 98155-1286
(206) 367-6069
(206) 367-6319
Mailing address
20011 BALLINGER WAY NE, STE C100, SHORELINE, WA 98155-1286
(206) 367-6069
(206) 367-6319

Taxonomy

Speciality
Code
Description
License number
State
261QP2000X
Physical Therapy Clinic/Center
Primary
PT00002011
WA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
8371353
WA
Enumeration date
04/01/2009
Last updated
04/20/2009
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