Provider Demographics
NPI:1528418381
Name:MCCLENNING, CHELSEA (PT, DPT)
Entity Type:Individual
Prefix:
First Name:CHELSEA
Middle Name:
Last Name:MCCLENNING
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15515 JUANITA WOODINVILLE WAY NE
Mailing Address - Street 2:APARTMENT K104
Mailing Address - City:BOTHELL
Mailing Address - State:WA
Mailing Address - Zip Code:98011-1576
Mailing Address - Country:US
Mailing Address - Phone:816-520-9229
Mailing Address - Fax:
Practice Address - Street 1:18504 BOTHELL WAY NE
Practice Address - Street 2:
Practice Address - City:BOTHELL
Practice Address - State:WA
Practice Address - Zip Code:98011-1927
Practice Address - Country:US
Practice Address - Phone:425-481-1933
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-06-13
Last Update Date:2016-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA60633205225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist