Provider Demographics
NPI:1437502036
Name:GARZA, STEPHANIE (PTA)
Entity Type:Individual
Prefix:
First Name:STEPHANIE
Middle Name:
Last Name:GARZA
Suffix:
Gender:F
Credentials:PTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3901 KERN WAY STE 102
Mailing Address - Street 2:
Mailing Address - City:YAKIMA
Mailing Address - State:WA
Mailing Address - Zip Code:98902-7804
Mailing Address - Country:US
Mailing Address - Phone:509-895-7449
Mailing Address - Fax:
Practice Address - Street 1:3901 KERN WAY STE 102
Practice Address - Street 2:
Practice Address - City:YAKIMA
Practice Address - State:WA
Practice Address - Zip Code:98902-7804
Practice Address - Country:US
Practice Address - Phone:509-895-7449
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-07-19
Last Update Date:2023-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
106S00000X
WAP1 60038142225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant
No106S00000XBehavioral Health & Social Service ProvidersBehavior Technician