Provider Demographics
NPI:1548216922
Name:LUCYK, ORYSIA A (PT)
Entity Type:Individual
Prefix:
First Name:ORYSIA
Middle Name:A
Last Name:LUCYK
Suffix:
Gender:F
Credentials:PT
Other - Prefix:MRS
Other - First Name:ORYSIA
Other - Middle Name:ANNA
Other - Last Name:LUCYK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:5343 TALLMAN AVE NW
Mailing Address - Street 2:SUITE 207
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98107-3931
Mailing Address - Country:US
Mailing Address - Phone:206-784-9935
Mailing Address - Fax:206-783-3281
Practice Address - Street 1:5343 TALLMAN AVE NW
Practice Address - Street 2:SUITE 207
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98107-3931
Practice Address - Country:US
Practice Address - Phone:206-784-9935
Practice Address - Fax:206-783-3281
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPT00005096225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA8358111Medicaid
WAAB37656Medicare ID - Type Unspecified