Provider Demographics
NPI:1225890247
Name:FEUERSTEIN, ALISA VIRGINIA
Entity Type:Individual
Prefix:
First Name:ALISA
Middle Name:VIRGINIA
Last Name:FEUERSTEIN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13425 SE 30TH ST STE 2C
Mailing Address - Street 2:
Mailing Address - City:BELLEVUE
Mailing Address - State:WA
Mailing Address - Zip Code:98005-4450
Mailing Address - Country:US
Mailing Address - Phone:425-800-4488
Mailing Address - Fax:425-201-2380
Practice Address - Street 1:13425 SE 30TH ST STE 2C
Practice Address - Street 2:
Practice Address - City:BELLEVUE
Practice Address - State:WA
Practice Address - Zip Code:98005-4450
Practice Address - Country:US
Practice Address - Phone:425-800-4488
Practice Address - Fax:425-201-2380
Is Sole Proprietor?:No
Enumeration Date:2024-01-25
Last Update Date:2024-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPT61479454225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist