Provider Demographics
NPI:1215379300
Name:BEALKO, COURTENEY JEAN (PT)
Entity Type:Individual
Prefix:
First Name:COURTENEY
Middle Name:JEAN
Last Name:BEALKO
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 1:1415 W DRAVUS ST
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98119-1716
Mailing Address - Country:US
Mailing Address - Phone:206-284-9088
Mailing Address - Fax:206-285-4946
Practice Address - Street 1:1415 W DRAVUS ST
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98119-1716
Practice Address - Country:US
Practice Address - Phone:206-284-9088
Practice Address - Fax:206-285-4946
Is Sole Proprietor?:No
Enumeration Date:2013-07-18
Last Update Date:2013-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPT00008630225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist