Provider Demographics
NPI:1326020926
Name:CLOTHIER, LORA J (DPT)
Entity Type:Individual
Prefix:
First Name:LORA
Middle Name:J
Last Name:CLOTHIER
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3727 CALIFORNIA AVE SW
Mailing Address - Street 2:SUITE 1-A
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98116-3753
Mailing Address - Country:US
Mailing Address - Phone:206-938-0860
Mailing Address - Fax:206-938-0866
Practice Address - Street 1:3727 CALIFORNIA AVE SW
Practice Address - Street 2:SUITE 1-A
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98116-4303
Practice Address - Country:US
Practice Address - Phone:206-938-0860
Practice Address - Fax:206-938-0866
Is Sole Proprietor?:Yes
Enumeration Date:2005-11-18
Last Update Date:2022-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPT000090272251S0007X, 225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
No2251S0007XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistSports
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA0282806OtherLABOR & INDUSTRIES
WA1193SCOtherREGENCE BLUE SHIELD
WAG8904843OtherMEDICARE PTAN
WA2103821Medicaid