Provider Demographics
NPI:1467898577
Name:LINEBERRY, ASHLEY M (PT,DPT, AT,C)
Entity Type:Individual
Prefix:
First Name:ASHLEY
Middle Name:M
Last Name:LINEBERRY
Suffix:
Gender:F
Credentials:PT,DPT, AT,C
Other - Prefix:
Other - First Name:ASHLEY
Other - Middle Name:M
Other - Last Name:MANRY
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:PT,DPT, AT,C
Mailing Address - Street 1:560 GAGE BLVD
Mailing Address - Street 2:SUITE 203
Mailing Address - City:RICHLAND
Mailing Address - State:WA
Mailing Address - Zip Code:99352
Mailing Address - Country:US
Mailing Address - Phone:509-942-3627
Mailing Address - Fax:509-942-2268
Practice Address - Street 1:875 SWIFT BLVD
Practice Address - Street 2:
Practice Address - City:RICHLAND
Practice Address - State:WA
Practice Address - Zip Code:99352
Practice Address - Country:US
Practice Address - Phone:509-946-1654
Practice Address - Fax:509-943-5652
Is Sole Proprietor?:No
Enumeration Date:2013-05-15
Last Update Date:2017-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA2305207924225100000X
WAPT60460882225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist