Provider Demographics
NPI:1073038741
Name:SAMBAS-HO, NOEMI LIEZL (PT, DPT)
Entity Type:Individual
Prefix:
First Name:NOEMI
Middle Name:LIEZL
Last Name:SAMBAS-HO
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:NOEMI
Other - Middle Name:LIEZL
Other - Last Name:SAMBAS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT, DPT
Mailing Address - Street 1:PO BOX 5299
Mailing Address - Street 2:MS: 820-5-PCO
Mailing Address - City:TACOMA
Mailing Address - State:WA
Mailing Address - Zip Code:98415-0299
Mailing Address - Country:US
Mailing Address - Phone:253-459-8009
Mailing Address - Fax:
Practice Address - Street 1:6704 TACOMA MALL BLVD STE 100
Practice Address - Street 2:
Practice Address - City:TACOMA
Practice Address - State:WA
Practice Address - Zip Code:98409-9001
Practice Address - Country:US
Practice Address - Phone:770-460-8609
Practice Address - Fax:770-460-8629
Is Sole Proprietor?:No
Enumeration Date:2017-08-03
Last Update Date:2023-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAPT013040225100000X
WAPT61464275225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist