Provider Demographics
NPI:1467460683
Name:MCGEE, BONNIE LEE (PT, OCS, ATC)
Entity Type:Individual
Prefix:MRS
First Name:BONNIE
Middle Name:LEE
Last Name:MCGEE
Suffix:
Gender:F
Credentials:PT, OCS, ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11430 51ST AVE NW
Mailing Address - Street 2:SUITE 101B
Mailing Address - City:GIG HARBOR
Mailing Address - State:WA
Mailing Address - Zip Code:98332-7897
Mailing Address - Country:US
Mailing Address - Phone:253-858-8555
Mailing Address - Fax:253-858-8560
Practice Address - Street 1:11430 51ST AVE NW
Practice Address - Street 2:SUITE 101B
Practice Address - City:GIG HARBOR
Practice Address - State:WA
Practice Address - Zip Code:98332-7897
Practice Address - Country:US
Practice Address - Phone:253-858-8555
Practice Address - Fax:253-858-8560
Is Sole Proprietor?:No
Enumeration Date:2006-08-03
Last Update Date:2007-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPT00007023174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA8367492Medicaid
WA0201460OtherLABOR AND INDUSTRIES
WA8367492Medicaid