Provider Demographics
NPI:1598924631
Name:FETCHERO, ALLISON JANE (DPT)
Entity Type:Individual
Prefix:
First Name:ALLISON
Middle Name:JANE
Last Name:FETCHERO
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:ALLISON
Other - Middle Name:JANE
Other - Last Name:CUDDY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DPT
Mailing Address - Street 1:BOX 359836
Mailing Address - Street 2:325 NINTH AVE
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98104
Mailing Address - Country:US
Mailing Address - Phone:206-744-2563
Mailing Address - Fax:206-744-8188
Practice Address - Street 1:325 NINTH AVE
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98104
Practice Address - Country:US
Practice Address - Phone:206-744-2563
Practice Address - Fax:206-744-8188
Is Sole Proprietor?:Yes
Enumeration Date:2008-06-04
Last Update Date:2010-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA2305205051225100000X
WAPT60119531225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist