Provider Demographics
NPI:1588801187
Name:ESMAILKA, LAUREN RAE (PT)
Entity Type:Individual
Prefix:
First Name:LAUREN
Middle Name:RAE
Last Name:ESMAILKA
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3603 S MCCLELLAN ST
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98144-5615
Mailing Address - Country:US
Mailing Address - Phone:206-535-7356
Mailing Address - Fax:
Practice Address - Street 1:3603 S MCCLELLAN ST
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98144-5615
Practice Address - Country:US
Practice Address - Phone:206-535-7356
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-01-19
Last Update Date:2020-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPT 60052211225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist