Provider Demographics
NPI:1760634182
Name:GHISONI MENASHI, MICHELLE ALLISON (MSPT, DPT)
Entity Type:Individual
Prefix:
First Name:MICHELLE
Middle Name:ALLISON
Last Name:GHISONI MENASHI
Suffix:
Gender:F
Credentials:MSPT, DPT
Other - Prefix:
Other - First Name:MICHELLE
Other - Middle Name:ALLISON
Other - Last Name:GHISONI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MSPT, DPT
Mailing Address - Street 1:PO BOX 3649
Mailing Address - Street 2:
Mailing Address - City:SPOKANE
Mailing Address - State:WA
Mailing Address - Zip Code:99220-3649
Mailing Address - Country:US
Mailing Address - Phone:509-838-2531
Mailing Address - Fax:
Practice Address - Street 1:15412 E SPRAGUE AVE
Practice Address - Street 2:SUITE 8
Practice Address - City:SPOKANE VALLEY
Practice Address - State:WA
Practice Address - Zip Code:99037-8841
Practice Address - Country:US
Practice Address - Phone:509-838-2531
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-10-16
Last Update Date:2008-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPT00010124225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist