Provider Demographics
NPI:1235517251
Name:CALHOUN, SUSAN CAROLINE (PT, DPT, MPT)
Entity Type:Individual
Prefix:
First Name:SUSAN
Middle Name:CAROLINE
Last Name:CALHOUN
Suffix:
Gender:F
Credentials:PT, DPT, MPT
Other - Prefix:
Other - First Name:SUSAN
Other - Middle Name:C
Other - Last Name:GRAHAM
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DPT
Mailing Address - Street 1:11800 NE 128TH ST STE 300
Mailing Address - Street 2:
Mailing Address - City:KIRKLAND
Mailing Address - State:WA
Mailing Address - Zip Code:98034-7211
Mailing Address - Country:US
Mailing Address - Phone:425-814-5100
Mailing Address - Fax:425-814-5103
Practice Address - Street 1:11800 NE 128TH ST STE 300
Practice Address - Street 2:
Practice Address - City:KIRKLAND
Practice Address - State:WA
Practice Address - Zip Code:98034-7211
Practice Address - Country:US
Practice Address - Phone:425-814-5100
Practice Address - Fax:425-814-5103
Is Sole Proprietor?:No
Enumeration Date:2015-05-11
Last Update Date:2022-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA61174149225100000X
GAPT006411225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist