Provider Demographics
NPI:1346381126
Name:KEEFER, TONYA JOELLE (DPT)
Entity Type:Individual
Prefix:MISS
First Name:TONYA
Middle Name:JOELLE
Last Name:KEEFER
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 1:3200 WEST MCGRAW
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98199-3208
Mailing Address - Country:US
Mailing Address - Phone:206-281-7970
Mailing Address - Fax:206-281-7980
Practice Address - Street 1:3200 WEST MCGRAW
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98199-3208
Practice Address - Country:US
Practice Address - Phone:206-281-7970
Practice Address - Fax:206-281-7980
Is Sole Proprietor?:No
Enumeration Date:2007-02-12
Last Update Date:2011-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPT0010270225100000X
WA00010270225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA8465114Medicaid
WA8865457Medicare ID - Type UnspecifiedMEDICARE NUMBER