Provider Demographics
NPI:1174672612
Name:METZGER, JANET J
Entity Type:Individual
Prefix:
First Name:JANET
Middle Name:J
Last Name:METZGER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:JANET
Other - Middle Name:DEE
Other - Last Name:JOHNSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT
Mailing Address - Street 1:PO BOX 731910
Mailing Address - Street 2:
Mailing Address - City:PUYALLUP
Mailing Address - State:WA
Mailing Address - Zip Code:98373
Mailing Address - Country:US
Mailing Address - Phone:253-845-0304
Mailing Address - Fax:253-845-0871
Practice Address - Street 1:823 MAIN STREET
Practice Address - Street 2:SUITE D
Practice Address - City:SUMNER
Practice Address - State:WA
Practice Address - Zip Code:98390
Practice Address - Country:US
Practice Address - Phone:253-845-0304
Practice Address - Fax:253-845-0871
Is Sole Proprietor?:No
Enumeration Date:2007-01-10
Last Update Date:2008-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WAG8852716Medicare PIN