Provider Demographics
NPI:1275672818
Name:BALDWIN, ELIZABETH A (PT)
Entity Type:Individual
Prefix:MRS
First Name:ELIZABETH
Middle Name:A
Last Name:BALDWIN
Suffix:
Gender:F
Credentials:PT
Other - Prefix:MISS
Other - First Name:ELIZABETH
Other - Middle Name:A
Other - Last Name:NAUGHTON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT
Mailing Address - Street 1:4417 149TH PL SW
Mailing Address - Street 2:
Mailing Address - City:LYNNWOOD
Mailing Address - State:WA
Mailing Address - Zip Code:98087-2243
Mailing Address - Country:US
Mailing Address - Phone:425-745-2528
Mailing Address - Fax:
Practice Address - Street 1:14 E CASINO RD
Practice Address - Street 2:
Practice Address - City:EVERETT
Practice Address - State:WA
Practice Address - Zip Code:98208-2628
Practice Address - Country:US
Practice Address - Phone:425-513-1663
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-02-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPT00000732225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist