Provider Demographics
NPI:1760856322
Name:TIMBREZA, DARLENE
Entity Type:Individual
Prefix:
First Name:DARLENE
Middle Name:
Last Name:TIMBREZA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:23013 MARINE VIEW DR S
Mailing Address - Street 2:B112
Mailing Address - City:DES MOINES
Mailing Address - State:WA
Mailing Address - Zip Code:98198-8480
Mailing Address - Country:US
Mailing Address - Phone:206-304-9293
Mailing Address - Fax:
Practice Address - Street 1:23013 MARINE VIEW DR S
Practice Address - Street 2:B112
Practice Address - City:DES MOINES
Practice Address - State:WA
Practice Address - Zip Code:98198-8480
Practice Address - Country:US
Practice Address - Phone:206-304-9293
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-11-19
Last Update Date:2015-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPT00010454225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist