Provider Demographics
NPI:1376648824
Name:HAYS, SUSAN (PT)
Entity Type:Individual
Prefix:
First Name:SUSAN
Middle Name:
Last Name:HAYS
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18710 MERIDIAN E
Mailing Address - Street 2:SUITE 215
Mailing Address - City:PUYALLUP
Mailing Address - State:WA
Mailing Address - Zip Code:98375-2231
Mailing Address - Country:US
Mailing Address - Phone:253-875-6826
Mailing Address - Fax:253-875-1547
Practice Address - Street 1:18710 MERIDIAN E
Practice Address - Street 2:SUITE 215
Practice Address - City:PUYALLUP
Practice Address - State:WA
Practice Address - Zip Code:98375-2231
Practice Address - Country:US
Practice Address - Phone:253-875-6826
Practice Address - Fax:253-875-1547
Is Sole Proprietor?:No
Enumeration Date:2006-09-13
Last Update Date:2021-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPT8262225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA8347155Medicaid
WA157604OtherLABOR & INDUSTRIES