Provider Demographics
NPI:1083288377
Name:FENTON, ALLISON (PT, DPT)
Entity Type:Individual
Prefix:
First Name:ALLISON
Middle Name:
Last Name:FENTON
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17792 147TH ST SE # 1030
Mailing Address - Street 2:
Mailing Address - City:MONROE
Mailing Address - State:WA
Mailing Address - Zip Code:98272-1030
Mailing Address - Country:US
Mailing Address - Phone:360-464-4358
Mailing Address - Fax:
Practice Address - Street 1:17792 147TH ST SE # 1030
Practice Address - Street 2:
Practice Address - City:MONROE
Practice Address - State:WA
Practice Address - Zip Code:98272-1030
Practice Address - Country:US
Practice Address - Phone:360-464-4358
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-05-19
Last Update Date:2022-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist