Provider Demographics
NPI:1467754374
Name:BEAN, AIMEE CHRISTINE (DPT)
Entity Type:Individual
Prefix:
First Name:AIMEE
Middle Name:CHRISTINE
Last Name:BEAN
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:AIMEE
Other - Middle Name:CHRISTINE
Other - Last Name:CLEMENTS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DPT
Mailing Address - Street 1:1740 LABOUNTY DR
Mailing Address - Street 2:STE 7
Mailing Address - City:FERNDALE
Mailing Address - State:WA
Mailing Address - Zip Code:98248-9403
Mailing Address - Country:US
Mailing Address - Phone:360-380-7336
Mailing Address - Fax:360-380-7310
Practice Address - Street 1:1740 LABOUNTY DR
Practice Address - Street 2:STE 7
Practice Address - City:FERNDALE
Practice Address - State:WA
Practice Address - Zip Code:98248-9403
Practice Address - Country:US
Practice Address - Phone:360-380-7336
Practice Address - Fax:360-380-7310
Is Sole Proprietor?:No
Enumeration Date:2010-11-29
Last Update Date:2013-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPT60167234225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist