Provider Demographics
NPI:1033592464
Name:RHODES, NATALIE M (PTA)
Entity Type:Individual
Prefix:
First Name:NATALIE
Middle Name:M
Last Name:RHODES
Suffix:
Gender:F
Credentials:PTA
Other - Prefix:
Other - First Name:NATALIE
Other - Middle Name:M
Other - Last Name:RASMUSSEN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:19217 36TH AVE W
Mailing Address - Street 2:SUIT 102
Mailing Address - City:LYNNWOOD
Mailing Address - State:WA
Mailing Address - Zip Code:98036-5751
Mailing Address - Country:US
Mailing Address - Phone:425-670-9991
Mailing Address - Fax:425-670-9995
Practice Address - Street 1:19217 36TH AVE W
Practice Address - Street 2:SUIT 102
Practice Address - City:LYNNWOOD
Practice Address - State:WA
Practice Address - Zip Code:98036-5751
Practice Address - Country:US
Practice Address - Phone:425-670-9991
Practice Address - Fax:425-670-9995
Is Sole Proprietor?:No
Enumeration Date:2015-07-02
Last Update Date:2015-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAP1 60430973225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
WAP1 60430973OtherLICENSE