Provider Demographics
NPI:1497001523
Name:VANVELZER, DEBORAH DEE (PT)
Entity Type:Individual
Prefix:MS
First Name:DEBORAH
Middle Name:DEE
Last Name:VANVELZER
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:410 PROVIDENCE LANE NE
Mailing Address - Street 2:
Mailing Address - City:OLYMPIA
Mailing Address - State:WA
Mailing Address - Zip Code:95806
Mailing Address - Country:US
Mailing Address - Phone:360-493-4995
Mailing Address - Fax:360-493-4470
Practice Address - Street 1:410 PROVIDENCE LANE NE
Practice Address - Street 2:
Practice Address - City:OLYMPIA
Practice Address - State:WA
Practice Address - Zip Code:95806
Practice Address - Country:US
Practice Address - Phone:360-493-4995
Practice Address - Fax:360-493-4470
Is Sole Proprietor?:No
Enumeration Date:2012-07-26
Last Update Date:2012-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPT00006352225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist