Provider Demographics
NPI:1578610333
Name:GAW, AMBER (MSPT)
Entity Type:Individual
Prefix:
First Name:AMBER
Middle Name:
Last Name:GAW
Suffix:
Gender:F
Credentials:MSPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4027 SUNNYSIDE AVE N
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98103-8434
Mailing Address - Country:US
Mailing Address - Phone:206-284-9764
Mailing Address - Fax:206-838-8481
Practice Address - Street 1:2103 QUEEN ANNE AVE N
Practice Address - Street 2:STE A
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98109-2311
Practice Address - Country:US
Practice Address - Phone:206-838-8480
Practice Address - Fax:206-838-8481
Is Sole Proprietor?:No
Enumeration Date:2007-01-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPT00009406225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA0212072OtherDEPT OF L&I
WA1598725798OtherGROUP NPI NUMBER