Provider Demographics
NPI:1518690189
Name:GILBERT, CHIAYO (DPT)
Entity Type:Individual
Prefix:
First Name:CHIAYO
Middle Name:
Last Name:GILBERT
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:CHIAYO
Other - Middle Name:
Other - Last Name:KOFFMAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:707 S PARK ST
Mailing Address - Street 2:
Mailing Address - City:DEER PARK
Mailing Address - State:WA
Mailing Address - Zip Code:99006-7025
Mailing Address - Country:US
Mailing Address - Phone:509-276-8811
Mailing Address - Fax:
Practice Address - Street 1:707 S PARK ST
Practice Address - Street 2:
Practice Address - City:DEER PARK
Practice Address - State:WA
Practice Address - Zip Code:99006-7025
Practice Address - Country:US
Practice Address - Phone:509-276-8811
Practice Address - Fax:866-629-4801
Is Sole Proprietor?:No
Enumeration Date:2022-07-01
Last Update Date:2022-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPU61313284225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist