Provider Demographics
NPI:1164546842
Name:LENTZ, AMY M (MPT)
Entity Type:Individual
Prefix:
First Name:AMY
Middle Name:M
Last Name:LENTZ
Suffix:
Gender:F
Credentials:MPT
Other - Prefix:
Other - First Name:AMY
Other - Middle Name:M L
Other - Last Name:MARSH
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:PT
Mailing Address - Street 1:7320 216TH ST SW STE 320
Mailing Address - Street 2:
Mailing Address - City:EDMONDS
Mailing Address - State:WA
Mailing Address - Zip Code:98026-8006
Mailing Address - Country:US
Mailing Address - Phone:425-673-3900
Mailing Address - Fax:425-673-3910
Practice Address - Street 1:190 W DAYTON ST
Practice Address - Street 2:SUITE 202
Practice Address - City:EDMONDS
Practice Address - State:WA
Practice Address - Zip Code:98020-4182
Practice Address - Country:US
Practice Address - Phone:425-582-8118
Practice Address - Fax:425-582-7420
Is Sole Proprietor?:No
Enumeration Date:2007-03-19
Last Update Date:2020-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPT000074072251X0800X, 225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
No2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA356736OtherWA LABOR & INDUSTRIES
WA2127684Medicaid