Provider Demographics
NPI:1063006021
Name:BUFORD, NYRENE (DPT)
Entity Type:Individual
Prefix:
First Name:NYRENE
Middle Name:
Last Name:BUFORD
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1911 SW CAMPUS DR # 336
Mailing Address - Street 2:
Mailing Address - City:FEDERAL WAY
Mailing Address - State:WA
Mailing Address - Zip Code:98023-6473
Mailing Address - Country:US
Mailing Address - Phone:206-304-6125
Mailing Address - Fax:
Practice Address - Street 1:16720 SE 271ST ST
Practice Address - Street 2:
Practice Address - City:COVINGTON
Practice Address - State:WA
Practice Address - Zip Code:98042-7342
Practice Address - Country:US
Practice Address - Phone:253-630-5808
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-02-21
Last Update Date:2021-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist