Provider Demographics
NPI:1265474688
Name:LINEHAN, MICHELLE FRYT (PT)
Entity Type:Individual
Prefix:
First Name:MICHELLE
Middle Name:FRYT
Last Name:LINEHAN
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 1:6125 S KANIKSU CT
Mailing Address - Street 2:
Mailing Address - City:SPOKANE
Mailing Address - State:WA
Mailing Address - Zip Code:99206-8360
Mailing Address - Country:US
Mailing Address - Phone:509-891-4938
Mailing Address - Fax:
Practice Address - Street 1:6125 S KANIKSU CT
Practice Address - Street 2:
Practice Address - City:SPOKANE
Practice Address - State:WA
Practice Address - Zip Code:99206-8360
Practice Address - Country:US
Practice Address - Phone:509-891-4938
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-06-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IDPT-2072225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist