Provider Demographics
NPI:1275679169
Name:MARKHAM, DEBORAH (RPT)
Entity Type:Individual
Prefix:
First Name:DEBORAH
Middle Name:
Last Name:MARKHAM
Suffix:
Gender:F
Credentials:RPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:32879 NE 40TH CIR
Mailing Address - Street 2:
Mailing Address - City:CARNATION
Mailing Address - State:WA
Mailing Address - Zip Code:98014-8712
Mailing Address - Country:US
Mailing Address - Phone:206-229-6309
Mailing Address - Fax:425-333-4210
Practice Address - Street 1:32879 NE 40TH CIR
Practice Address - Street 2:
Practice Address - City:CARNATION
Practice Address - State:WA
Practice Address - Zip Code:98014-8712
Practice Address - Country:US
Practice Address - Phone:206-229-6309
Practice Address - Fax:425-333-4210
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-29
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPT00002708225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA7043672Medicaid