Provider Demographics
NPI:1356648786
Name:LAIGO, RENEE LYNN (MPT)
Entity Type:Individual
Prefix:MRS
First Name:RENEE
Middle Name:LYNN
Last Name:LAIGO
Suffix:
Gender:F
Credentials:MPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1116 NE 195TH CT
Mailing Address - Street 2:
Mailing Address - City:SHORELINE
Mailing Address - State:WA
Mailing Address - Zip Code:98155-1100
Mailing Address - Country:US
Mailing Address - Phone:206-306-1021
Mailing Address - Fax:
Practice Address - Street 1:1116 NE 195TH CT
Practice Address - Street 2:
Practice Address - City:SHORELINE
Practice Address - State:WA
Practice Address - Zip Code:98155-1100
Practice Address - Country:US
Practice Address - Phone:206-306-1021
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-02-21
Last Update Date:2011-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA7575225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist