Provider Demographics
NPI:1508239864
Name:BEAUDRY, ALISON M (DPT)
Entity Type:Individual
Prefix:
First Name:ALISON
Middle Name:M
Last Name:BEAUDRY
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4550 KLAHANIE DR SE
Mailing Address - Street 2:
Mailing Address - City:ISSAQUAH
Mailing Address - State:WA
Mailing Address - Zip Code:98029-5812
Mailing Address - Country:US
Mailing Address - Phone:425-391-2427
Mailing Address - Fax:425-392-4098
Practice Address - Street 1:7726 CENTER BLVD SE STE 220
Practice Address - Street 2:
Practice Address - City:SNOQUALMIE
Practice Address - State:WA
Practice Address - Zip Code:98065-8753
Practice Address - Country:US
Practice Address - Phone:425-396-7778
Practice Address - Fax:425-396-7097
Is Sole Proprietor?:No
Enumeration Date:2015-11-09
Last Update Date:2021-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPT60596814225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist