Provider Demographics
NPI:1275032393
Name:PHILLIPS, MORGAN (PT, DPT)
Entity Type:Individual
Prefix:
First Name:MORGAN
Middle Name:
Last Name:PHILLIPS
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 DENNIS ST SW
Mailing Address - Street 2:STE B
Mailing Address - City:TUMWATER
Mailing Address - State:WA
Mailing Address - Zip Code:98501-6523
Mailing Address - Country:US
Mailing Address - Phone:360-338-0181
Mailing Address - Fax:
Practice Address - Street 1:417 W YELM AVENUE
Practice Address - Street 2:
Practice Address - City:YELM
Practice Address - State:WA
Practice Address - Zip Code:98597-9859
Practice Address - Country:US
Practice Address - Phone:360-458-2444
Practice Address - Fax:360-458-2747
Is Sole Proprietor?:No
Enumeration Date:2018-02-04
Last Update Date:2020-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK5420225100000X
WAPT60864481225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist