Provider Demographics
NPI:1033260583
Name:DELIZO, CATHY JEAN (PT)
Entity Type:Individual
Prefix:MRS
First Name:CATHY
Middle Name:JEAN
Last Name:DELIZO
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2130 201ST PL SW
Mailing Address - Street 2:
Mailing Address - City:LYNNWOOD
Mailing Address - State:WA
Mailing Address - Zip Code:98036-7018
Mailing Address - Country:US
Mailing Address - Phone:425-422-5250
Mailing Address - Fax:
Practice Address - Street 1:13410 HIGHWAY 99 STE 204
Practice Address - Street 2:
Practice Address - City:EVERETT
Practice Address - State:WA
Practice Address - Zip Code:98204-5454
Practice Address - Country:US
Practice Address - Phone:425-742-7300
Practice Address - Fax:425-742-7334
Is Sole Proprietor?:No
Enumeration Date:2007-01-12
Last Update Date:2020-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPT00003335225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA7075294Medicaid
WA7075294Medicaid