Provider Demographics
NPI:1417068289
Name:IRWIN-SIRES, DEANNA E (PT)
Entity Type:Individual
Prefix:
First Name:DEANNA
Middle Name:E
Last Name:IRWIN-SIRES
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:DEANNA
Other - Middle Name:E
Other - Last Name:IRWIN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:5417 IVANHOE PL NE
Mailing Address - Street 2:SUITE 110
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98105-2838
Mailing Address - Country:US
Mailing Address - Phone:206-498-8496
Mailing Address - Fax:
Practice Address - Street 1:5124 NE LATIMER PL
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98105-4954
Practice Address - Country:US
Practice Address - Phone:206-498-8496
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-31
Last Update Date:2012-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPT00006079225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist