Provider Demographics
NPI:1477553097
Name:WOERMAN, ALLYN L (MMSC, PT)
Entity Type:Individual
Prefix:
First Name:ALLYN
Middle Name:L
Last Name:WOERMAN
Suffix:
Gender:M
Credentials:MMSC, PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13221 76TH AVENUE CT E
Mailing Address - Street 2:
Mailing Address - City:PUYALLUP
Mailing Address - State:WA
Mailing Address - Zip Code:98373-5471
Mailing Address - Country:US
Mailing Address - Phone:253-536-9926
Mailing Address - Fax:253-536-9926
Practice Address - Street 1:13221 76TH AVENUE CT E
Practice Address - Street 2:
Practice Address - City:PUYALLUP
Practice Address - State:WA
Practice Address - Zip Code:98373-5471
Practice Address - Country:US
Practice Address - Phone:253-536-9926
Practice Address - Fax:253-536-9926
Is Sole Proprietor?:No
Enumeration Date:2005-07-26
Last Update Date:2012-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPT5337225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA7092216Medicaid
WA7092216Medicaid