Provider Demographics
NPI:1598055303
Name:LEOVAO-CARPEL, NAOMI TRISHA (DPT)
Entity Type:Individual
Prefix:
First Name:NAOMI TRISHA
Middle Name:
Last Name:LEOVAO-CARPEL
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:NAOMI
Other - Middle Name:
Other - Last Name:LEOVAO-CARPEL
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:DPT
Mailing Address - Street 1:9800 4TH AVE NE
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98115-2152
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:9800 4TH AVE NE
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98115-2152
Practice Address - Country:US
Practice Address - Phone:206-302-1421
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-04-13
Last Update Date:2011-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA60188701225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist