Provider Demographics
NPI:1619012929
Name:ARMANTROUT, ELAINE ANN (PT, DSC, ECS)
Entity Type:Individual
Prefix:DR
First Name:ELAINE
Middle Name:ANN
Last Name:ARMANTROUT
Suffix:
Gender:F
Credentials:PT, DSC, ECS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3050 38TH AVE W
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98199-2513
Mailing Address - Country:US
Mailing Address - Phone:206-940-9487
Mailing Address - Fax:
Practice Address - Street 1:785 SE BAYSHORE DR
Practice Address - Street 2:SUITE 102
Practice Address - City:OAK HARBOR
Practice Address - State:WA
Practice Address - Zip Code:98277-3275
Practice Address - Country:US
Practice Address - Phone:360-279-8323
Practice Address - Fax:360-279-8772
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-21
Last Update Date:2015-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPT000029812251E1300X, 225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
No2251E1300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistElectrophysiology, Clinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA8445744Medicaid
WAGAB21524Medicare PIN
WAGAB21525Medicare PIN
WAGAB21527Medicare PIN
WAG8869168Medicare PIN
WAGAB21526Medicare PIN
WAGAB21523Medicare PIN
WAG8933268Medicare PIN
WAP00149544Medicare PIN
WA8445744Medicaid