Provider Demographics
NPI:1093767832
Name:LAW, RHONDA E (PT)
Entity Type:Individual
Prefix:MRS
First Name:RHONDA
Middle Name:E
Last Name:LAW
Suffix:
Gender:F
Credentials:PT
Other - Prefix:MRS
Other - First Name:RHONDA
Other - Middle Name:E
Other - Last Name:CARLSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:4300 LAKE HELENA ROAD
Mailing Address - Street 2:
Mailing Address - City:PORT ORCHARD
Mailing Address - State:WA
Mailing Address - Zip Code:98367
Mailing Address - Country:US
Mailing Address - Phone:360-895-4017
Mailing Address - Fax:
Practice Address - Street 1:1880 POTTERY AVE
Practice Address - Street 2:SUITE 100
Practice Address - City:PORT ORCHARD
Practice Address - State:WA
Practice Address - Zip Code:98366
Practice Address - Country:US
Practice Address - Phone:360-895-9090
Practice Address - Fax:360-895-9089
Is Sole Proprietor?:No
Enumeration Date:2006-05-17
Last Update Date:2020-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPT00003991225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA8339350Medicaid
912075994OtherKETSAP PHYSICAL THEREP SP
WA0159012OtherL I
P00129558OtherRAILROAD MEDICARE