Individual
JUANITA LOUISE NIRIDER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
4518 48 ST CT E, TACOMA, WA 98443-2568
(253) 820-4008
Mailing address
4518 48 ST CT E, TACOMA, WA 98443-2568
(253) 820-4008
Taxonomy
Speciality
Code
Description
License number
State
2251P0200X
Pediatric Physical Therapist
Primary
PT00003609
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7125743
—
WA
Enumeration date
12/13/2006
Last updated
07/09/2007
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