Provider Demographics
NPI:1174849004
Name:HAIJ, GITA (DPT)
Entity Type:Individual
Prefix:MRS
First Name:GITA
Middle Name:
Last Name:HAIJ
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9515 NW 23RD CT
Mailing Address - Street 2:
Mailing Address - City:VANCOUVER
Mailing Address - State:WA
Mailing Address - Zip Code:98665-6669
Mailing Address - Country:US
Mailing Address - Phone:360-241-1010
Mailing Address - Fax:
Practice Address - Street 1:9515 NW 23RD CT
Practice Address - Street 2:
Practice Address - City:VANCOUVER
Practice Address - State:WA
Practice Address - Zip Code:98665-6669
Practice Address - Country:US
Practice Address - Phone:360-241-1010
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-04-16
Last Update Date:2010-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPT 00010534225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist