Provider Demographics
NPI:1437357878
Name:MCPHERSON, MYRA J (PT)
Entity Type:Individual
Prefix:
First Name:MYRA
Middle Name:J
Last Name:MCPHERSON
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1519 132ND ST SE
Mailing Address - Street 2:SUITE A
Mailing Address - City:EVERETT
Mailing Address - State:WA
Mailing Address - Zip Code:98208-7203
Mailing Address - Country:US
Mailing Address - Phone:425-330-0633
Mailing Address - Fax:425-338-9637
Practice Address - Street 1:7728 204TH ST NE
Practice Address - Street 2:SUITE A
Practice Address - City:ARLINGTON
Practice Address - State:WA
Practice Address - Zip Code:98223-2500
Practice Address - Country:US
Practice Address - Phone:360-403-8250
Practice Address - Fax:360-403-0917
Is Sole Proprietor?:No
Enumeration Date:2007-07-06
Last Update Date:2012-01-25
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
WAPT00008724225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA8936602OtherL&I CRIME VICTIMS
WA8336265Medicaid
WA0223730OtherDEPT OF L&I
WA2452MCOtherREGENCE BLUESHIELD
WA650023091OtherRAILROAD MEDICARE
WA7235320OtherAETNA
WA7235320OtherAETNA