Provider Demographics
NPI:1093189318
Name:ASPIRIN, LIDA JOY
Entity Type:Individual
Prefix:
First Name:LIDA JOY
Middle Name:
Last Name:ASPIRIN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:LIDA JOY
Other - Middle Name:G
Other - Last Name:RADAZA
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:1920 70TH AVE W
Mailing Address - Street 2:APT E4
Mailing Address - City:UNIVERSITY PLACE
Mailing Address - State:WA
Mailing Address - Zip Code:98466-5511
Mailing Address - Country:US
Mailing Address - Phone:253-314-1215
Mailing Address - Fax:
Practice Address - Street 1:1920 70TH AVE W
Practice Address - Street 2:APT E4
Practice Address - City:UNIVERSITY PLACE
Practice Address - State:WA
Practice Address - Zip Code:98466-5511
Practice Address - Country:US
Practice Address - Phone:253-314-1215
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-11-24
Last Update Date:2015-11-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPT 60477316225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist