Provider Demographics
NPI:1033885835
Name:TRISKO, MEAGAN (PT)
Entity Type:Individual
Prefix:
First Name:MEAGAN
Middle Name:
Last Name:TRISKO
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 1:1407 E 72ND ST STE A100
Mailing Address - Street 2:
Mailing Address - City:TACOMA
Mailing Address - State:WA
Mailing Address - Zip Code:98404-5906
Mailing Address - Country:US
Mailing Address - Phone:253-474-7474
Mailing Address - Fax:
Practice Address - Street 1:1407 E 72ND ST STE A100
Practice Address - Street 2:
Practice Address - City:TACOMA
Practice Address - State:WA
Practice Address - Zip Code:98404-5906
Practice Address - Country:US
Practice Address - Phone:253-474-7474
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-08-20
Last Update Date:2021-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPT61176974225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist