Provider Demographics
NPI:1376897371
Name:FEDERSPIEL, CARA SUZANNE (PHYSICAL THERAPIST)
Entity Type:Individual
Prefix:
First Name:CARA
Middle Name:SUZANNE
Last Name:FEDERSPIEL
Suffix:
Gender:F
Credentials:PHYSICAL THERAPIST
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Mailing Address - Street 1:906 SE EVERETT MALL WAY STE 200
Mailing Address - Street 2:
Mailing Address - City:EVERETT
Mailing Address - State:WA
Mailing Address - Zip Code:98208-3743
Mailing Address - Country:US
Mailing Address - Phone:425-353-5656
Mailing Address - Fax:425-513-2807
Practice Address - Street 1:906 SE EVERETT MALL WAY STE 200
Practice Address - Street 2:
Practice Address - City:EVERETT
Practice Address - State:WA
Practice Address - Zip Code:98208-3743
Practice Address - Country:US
Practice Address - Phone:425-353-5656
Practice Address - Fax:425-513-2807
Is Sole Proprietor?:No
Enumeration Date:2012-10-30
Last Update Date:2019-12-23
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
WAPT000066992251P0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251P0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistPediatrics