Provider Demographics
NPI:1538490305
Name:FROST, MIRIAM (PT, CLT)
Entity Type:Individual
Prefix:MRS
First Name:MIRIAM
Middle Name:
Last Name:FROST
Suffix:
Gender:F
Credentials:PT, CLT
Other - Prefix:
Other - First Name:MIRIAM
Other - Middle Name:
Other - Last Name:DEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT
Mailing Address - Street 1:1322 N ASH ST
Mailing Address - Street 2:
Mailing Address - City:SPOKANE
Mailing Address - State:WA
Mailing Address - Zip Code:99201-2804
Mailing Address - Country:US
Mailing Address - Phone:509-326-2300
Mailing Address - Fax:509-326-8635
Practice Address - Street 1:1322 N ASH ST
Practice Address - Street 2:
Practice Address - City:SPOKANE
Practice Address - State:WA
Practice Address - Zip Code:99201-2804
Practice Address - Country:US
Practice Address - Phone:509-326-2300
Practice Address - Fax:509-326-8635
Is Sole Proprietor?:No
Enumeration Date:2010-01-19
Last Update Date:2010-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPT00010371225100000X
CAPT17052225100000X
IDPT2181225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist