Provider Demographics
NPI:1235493636
Name:NOVOA, EMILY MITIGUY (DPT)
Entity Type:Individual
Prefix:
First Name:EMILY
Middle Name:MITIGUY
Last Name:NOVOA
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:EMILY
Other - Middle Name:MITIGUY
Other - Last Name:MILLER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DPT
Mailing Address - Street 1:PO BOX 5299
Mailing Address - Street 2:MS: 820-5-PCO
Mailing Address - City:TACOMA
Mailing Address - State:WA
Mailing Address - Zip Code:98415-0299
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:601 MCPHEE RD SW BLDG 1
Practice Address - Street 2:
Practice Address - City:OLYMPIA
Practice Address - State:WA
Practice Address - Zip Code:98502-5080
Practice Address - Country:US
Practice Address - Phone:360-596-4614
Practice Address - Fax:360-596-4615
Is Sole Proprietor?:No
Enumeration Date:2012-06-29
Last Update Date:2024-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPT60543495225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist