Provider Demographics
NPI:1578319836
Name:EDWARDS, IWONA (DPT)
Entity Type:Individual
Prefix:
First Name:IWONA
Middle Name:
Last Name:EDWARDS
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:IWOAN
Other - Middle Name:
Other - Last Name:KLAPA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DPT
Mailing Address - Street 1:917 SW 31ST ST APT 303A
Mailing Address - Street 2:
Mailing Address - City:BATTLE GROUND
Mailing Address - State:WA
Mailing Address - Zip Code:98604-5934
Mailing Address - Country:US
Mailing Address - Phone:716-949-6386
Mailing Address - Fax:
Practice Address - Street 1:200 TRIANGLE SHOPPING CTR STE 270
Practice Address - Street 2:
Practice Address - City:LONGVIEW
Practice Address - State:WA
Practice Address - Zip Code:98632-4684
Practice Address - Country:US
Practice Address - Phone:360-583-4976
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-04-27
Last Update Date:2024-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AKPHYP2102225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist