Provider Demographics
NPI:1679020820
Name:STEWART, ADISON (PTA)
Entity Type:Individual
Prefix:
First Name:ADISON
Middle Name:
Last Name:STEWART
Suffix:
Gender:F
Credentials:PTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4206 W 24TH AVE STE B104
Mailing Address - Street 2:
Mailing Address - City:KENNEWICK
Mailing Address - State:WA
Mailing Address - Zip Code:99338-2321
Mailing Address - Country:US
Mailing Address - Phone:509-572-2299
Mailing Address - Fax:866-844-3735
Practice Address - Street 1:4206 W 24TH AVE STE B104
Practice Address - Street 2:
Practice Address - City:KENNEWICK
Practice Address - State:WA
Practice Address - Zip Code:99338-2321
Practice Address - Country:US
Practice Address - Phone:509-572-2299
Practice Address - Fax:866-844-3735
Is Sole Proprietor?:No
Enumeration Date:2016-09-06
Last Update Date:2016-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251P0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistPediatrics