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Individual

CONNIE JEAN DE MARIA

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
PTA

Contact information

Practice address
116 FAIRVIEW AVE N, SEATTLE, WA 98109-5360
(206) 254-1456
Mailing address
7001 SEAVIEW AVE NW STE 160, SEATTLE, WA 98117-6021
(206) 861-4653

Taxonomy

Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
P160039700
WA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
P160039700
WASHINGTON STATE DEPARTMENT OF HEALTH PHYSICAL THERAPIST ASSISTANT
WA
Enumeration date
11/15/2015
Last updated
11/21/2025
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