Provider Demographics
NPI:1154472686
Name:BISSON, MAREN (PT)
Entity Type:Individual
Prefix:
First Name:MAREN
Middle Name:
Last Name:BISSON
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3052 60TH AVE SW
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98116-2807
Mailing Address - Country:US
Mailing Address - Phone:206-922-9230
Mailing Address - Fax:
Practice Address - Street 1:19820 SCRIBER LAKE RD
Practice Address - Street 2:
Practice Address - City:LYNNWOOD
Practice Address - State:WA
Practice Address - Zip Code:98036-6121
Practice Address - Country:US
Practice Address - Phone:425-673-5220
Practice Address - Fax:425-673-1597
Is Sole Proprietor?:No
Enumeration Date:2007-01-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPT00008045225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist