Provider Demographics
NPI:1760639561
Name:PHILIPPEN, SANDRA (DPT)
Entity Type:Individual
Prefix:
First Name:SANDRA
Middle Name:
Last Name:PHILIPPEN
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:950 22ND AVE
Mailing Address - Street 2:B
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98122-4808
Mailing Address - Country:US
Mailing Address - Phone:206-598-4830
Mailing Address - Fax:
Practice Address - Street 1:950 22ND AVE
Practice Address - Street 2:B
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98122-4808
Practice Address - Country:US
Practice Address - Phone:206-598-4830
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-08-22
Last Update Date:2008-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPT60028816225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist