Provider Demographics
NPI:1659464287
Name:PREDMORE, LORI KAYE (PT)
Entity Type:Individual
Prefix:MRS
First Name:LORI
Middle Name:KAYE
Last Name:PREDMORE
Suffix:
Gender:F
Credentials:PT
Other - Prefix:MISS
Other - First Name:LORI
Other - Middle Name:KAYE
Other - Last Name:PREDMORE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT
Mailing Address - Street 1:3225 NE 125TH ST
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98125
Mailing Address - Country:US
Mailing Address - Phone:206-417-1298
Mailing Address - Fax:206-417-1299
Practice Address - Street 1:3225 NE 125TH ST
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98125
Practice Address - Country:US
Practice Address - Phone:206-417-1298
Practice Address - Fax:206-417-1299
Is Sole Proprietor?:No
Enumeration Date:2006-10-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPT00005233225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist