Provider Demographics
NPI:1730651670
Name:HA, MOLLY SORDS (DPT)
Entity Type:Individual
Prefix:
First Name:MOLLY
Middle Name:SORDS
Last Name:HA
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:MOLLY
Other - Middle Name:REBECCA
Other - Last Name:SORDS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:19603 9TH DR SE
Mailing Address - Street 2:
Mailing Address - City:BOTHELL
Mailing Address - State:WA
Mailing Address - Zip Code:98012-7764
Mailing Address - Country:US
Mailing Address - Phone:216-789-9157
Mailing Address - Fax:
Practice Address - Street 1:12900 NE 180TH ST STE 110
Practice Address - Street 2:
Practice Address - City:BOTHELL
Practice Address - State:WA
Practice Address - Zip Code:98011-5773
Practice Address - Country:US
Practice Address - Phone:425-483-4270
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-12-17
Last Update Date:2024-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA60897303225100000X
WAPT60897303225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist