Individual
CHARMAINE R MINNIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
123 E JOHNSON AVE, CHELAN, WA 98816
(509) 682-4713
(509) 682-3218
Mailing address
PO BOX 6, CHELAN, WA 98816-0006
(509) 682-4713
(509) 682-3218
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
025208 PT00006114
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
161721
PERSONAL L&I ID
WA
05
—
8335622
—
WA
Enumeration date
11/07/2005
Last updated
01/30/2014
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