Provider Demographics
NPI:1447390026
Name:GREELEY, KAREN L (PT, OCS, COMT,)
Entity Type:Individual
Prefix:
First Name:KAREN
Middle Name:L
Last Name:GREELEY
Suffix:
Gender:F
Credentials:PT, OCS, COMT,
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3221 EASTLAKE AVE E STE 110
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98102-7125
Mailing Address - Country:US
Mailing Address - Phone:206-696-9475
Mailing Address - Fax:206-860-3746
Practice Address - Street 1:3221 EASTLAKE AVE E STE 110
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98102-7125
Practice Address - Country:US
Practice Address - Phone:206-641-7733
Practice Address - Fax:206-641-3272
Is Sole Proprietor?:No
Enumeration Date:2007-02-06
Last Update Date:2022-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPT000039592081S0010X, 2251X0800X, 225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
No2081S0010XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationSports Medicine
No2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA8350936Medicaid
WA8350936Medicaid