Provider Demographics
NPI:1497927560
Name:PALMIOTTO, BRENDA LEE (PT)
Entity Type:Individual
Prefix:MS
First Name:BRENDA
Middle Name:LEE
Last Name:PALMIOTTO
Suffix:
Gender:F
Credentials:PT
Other - Prefix:MS
Other - First Name:BRENDA
Other - Middle Name:LEE
Other - Last Name:HANSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT
Mailing Address - Street 1:600 NW GILMAN BLVD
Mailing Address - Street 2:SUITE A
Mailing Address - City:ISSAQUAH
Mailing Address - State:WA
Mailing Address - Zip Code:98027-2445
Mailing Address - Country:US
Mailing Address - Phone:425-313-3055
Mailing Address - Fax:425-313-3051
Practice Address - Street 1:600 NW GILMAN BLVD
Practice Address - Street 2:SUITE A
Practice Address - City:ISSAQUAH
Practice Address - State:WA
Practice Address - Zip Code:98027-2445
Practice Address - Country:US
Practice Address - Phone:425-313-3055
Practice Address - Fax:425-313-3051
Is Sole Proprietor?:No
Enumeration Date:2008-03-29
Last Update Date:2008-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPT00010786225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist