Provider Demographics
NPI:1144427634
Name:ROGERS, STEPHANIE C (MSPT)
Entity Type:Individual
Prefix:
First Name:STEPHANIE
Middle Name:C
Last Name:ROGERS
Suffix:
Gender:F
Credentials:MSPT
Other - Prefix:
Other - First Name:STEPHANIE
Other - Middle Name:CR
Other - Last Name:STURHAM
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MSPT
Mailing Address - Street 1:3550 W BLAKELY AVE NE
Mailing Address - Street 2:
Mailing Address - City:BAINBRIDGE ISLAND
Mailing Address - State:WA
Mailing Address - Zip Code:98110-2205
Mailing Address - Country:US
Mailing Address - Phone:206-427-8202
Mailing Address - Fax:206-238-9142
Practice Address - Street 1:3550 W BLAKELY AVE NE
Practice Address - Street 2:
Practice Address - City:BAINBRIDGE ISLAND
Practice Address - State:WA
Practice Address - Zip Code:98110-2205
Practice Address - Country:US
Practice Address - Phone:206-427-8202
Practice Address - Fax:206-238-9142
Is Sole Proprietor?:No
Enumeration Date:2007-06-28
Last Update Date:2024-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPT00008360225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist