Individual
MS. MARSHA LYNN DOUGHERTY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MS, PT
Contact information
Practice address
2430 N 13TH ST, SHELTON, WA 98584-1213
(360) 426-1651
Mailing address
2033 EXCELSIOR DR SE, OLYMPIA, WA 98501-3775
(360) 464-7459
Taxonomy
Speciality
Code
Description
License number
State
2251G0304X
Geriatric Physical Therapist
Primary
PT00010578
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
PT00010578
DEPARTMENT OF HEALTH
WA
Enumeration date
02/23/2009
Last updated
02/23/2009
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