Provider Demographics
NPI:1083004253
Name:CRAIG, SHONA SUTHERLAND (DPT)
Entity Type:Individual
Prefix:
First Name:SHONA
Middle Name:SUTHERLAND
Last Name:CRAIG
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 1:1455 COLUMBIA PARK TRAIL
Mailing Address - Street 2:
Mailing Address - City:RICHLAND
Mailing Address - State:WA
Mailing Address - Zip Code:99352-4721
Mailing Address - Country:US
Mailing Address - Phone:509-396-3707
Mailing Address - Fax:509-396-3710
Practice Address - Street 1:1455 COLUMBIA PARK TRAIL
Practice Address - Street 2:
Practice Address - City:RICHLAND
Practice Address - State:WA
Practice Address - Zip Code:99352-4721
Practice Address - Country:US
Practice Address - Phone:509-396-3707
Practice Address - Fax:509-396-3710
Is Sole Proprietor?:No
Enumeration Date:2015-01-27
Last Update Date:2015-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPT60524050225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist