Provider Demographics
NPI:1275009334
Name:SIVRET, DEANNA CHRISTINE LEONARD (PT)
Entity Type:Individual
Prefix:
First Name:DEANNA
Middle Name:CHRISTINE LEONARD
Last Name:SIVRET
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:DEANNA
Other - Middle Name:CHRISTINE
Other - Last Name:LEONARD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1249 ROLAND ST
Mailing Address - Street 2:
Mailing Address - City:BELLINGHAM
Mailing Address - State:WA
Mailing Address - Zip Code:98229-2407
Mailing Address - Country:US
Mailing Address - Phone:360-305-8117
Mailing Address - Fax:
Practice Address - Street 1:1249 ROLAND ST
Practice Address - Street 2:
Practice Address - City:BELLINGHAM
Practice Address - State:WA
Practice Address - Zip Code:98229-2407
Practice Address - Country:US
Practice Address - Phone:360-305-8117
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-10-16
Last Update Date:2018-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPT00006279225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist