Provider Demographics
NPI:1629378765
Name:ZETLEN, JANIS MILNE (DPT)
Entity Type:Individual
Prefix:
First Name:JANIS
Middle Name:MILNE
Last Name:ZETLEN
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1305 QUEEN ANNE AVE N
Mailing Address - Street 2:APT 208
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98109-5738
Mailing Address - Country:US
Mailing Address - Phone:206-399-9877
Mailing Address - Fax:
Practice Address - Street 1:1305 QUEEN ANNE AVE N
Practice Address - Street 2:APT 208
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98109-5738
Practice Address - Country:US
Practice Address - Phone:206-399-9877
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-10-22
Last Update Date:2010-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPT60164880225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist