Provider Demographics
NPI:1730307398
Name:CREED, VANESSA DANRIB ROMEROSO (DPT)
Entity Type:Individual
Prefix:MISS
First Name:VANESSA DANRIB
Middle Name:ROMEROSO
Last Name:CREED
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Mailing Address - Street 1:463 TREMONT ST W STE 100
Mailing Address - Street 2:
Mailing Address - City:PORT ORCHARD
Mailing Address - State:WA
Mailing Address - Zip Code:98366-3743
Mailing Address - Country:US
Mailing Address - Phone:360-874-0745
Mailing Address - Fax:360-874-0846
Practice Address - Street 1:463 TREMONT ST W STE 100
Practice Address - Street 2:
Practice Address - City:PORT ORCHARD
Practice Address - State:WA
Practice Address - Zip Code:98366-3743
Practice Address - Country:US
Practice Address - Phone:360-874-0745
Practice Address - Fax:360-874-0846
Is Sole Proprietor?:No
Enumeration Date:2007-04-20
Last Update Date:2022-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJPT40QA01191100225100000X
WAPT602612092251G0304X, 225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
No2251G0304XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGeriatrics