Provider Demographics
NPI:1750321121
Name:MURRAY, MONICA CLARE (BSPT)
Entity Type:Individual
Prefix:
First Name:MONICA
Middle Name:CLARE
Last Name:MURRAY
Suffix:
Gender:F
Credentials:BSPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9315 GRAVELLY LAKE DR SW
Mailing Address - Street 2:SUITE 203
Mailing Address - City:LAKEWOOD
Mailing Address - State:WA
Mailing Address - Zip Code:98499-1574
Mailing Address - Country:US
Mailing Address - Phone:253-581-5200
Mailing Address - Fax:253-581-5203
Practice Address - Street 1:7727 40TH ST W
Practice Address - Street 2:SUITE A
Practice Address - City:UNIVERSITY PLACE
Practice Address - State:WA
Practice Address - Zip Code:98466-3146
Practice Address - Country:US
Practice Address - Phone:253-460-1362
Practice Address - Fax:253-460-6628
Is Sole Proprietor?:No
Enumeration Date:2006-06-07
Last Update Date:2008-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPT00006294225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA8441842Medicaid
WA4677MUOtherBLUE SHIELD # VM
WA0206081OtherLABOR & INDUSTRIES
WA7715MUOtherREGENCE BLUESHIELD
WA8940832OtherL&I CRIME VICTIMS PRGM
WA4677MUOtherBLUE SHIELD # VM
WA8441842Medicaid