Provider Demographics
NPI:1447233770
Name:LOVEJOY-EVANS, LORAINE (MPT, DPT)
Entity Type:Individual
Prefix:MRS
First Name:LORAINE
Middle Name:
Last Name:LOVEJOY-EVANS
Suffix:
Gender:F
Credentials:MPT, DPT
Other - Prefix:
Other - First Name:INDEPENDENCE
Other - Middle Name:THROUGH
Other - Last Name:PHYSICAL THERAPY
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 572
Mailing Address - Street 2:
Mailing Address - City:CARLSBORG
Mailing Address - State:WA
Mailing Address - Zip Code:98324-0572
Mailing Address - Country:US
Mailing Address - Phone:360-683-6101
Mailing Address - Fax:360-683-6102
Practice Address - Street 1:865 CARLSBORG RD
Practice Address - Street 2:SUITE C
Practice Address - City:SEQUIM
Practice Address - State:WA
Practice Address - Zip Code:98382-8390
Practice Address - Country:US
Practice Address - Phone:360-683-6101
Practice Address - Fax:360-683-6102
Is Sole Proprietor?:Yes
Enumeration Date:2005-11-21
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPT00005999225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA0160256OtherLABOR & INDUSTRIES
WA9259LOOtherREGENCE
WA8324568Medicaid
WA9259LOOtherREGENCE
WA0160256OtherLABOR & INDUSTRIES
WA8324568Medicaid