Provider Demographics
NPI:1801363502
Name:MAGGIO, BIANCA MARIE (DPT)
Entity Type:Individual
Prefix:
First Name:BIANCA
Middle Name:MARIE
Last Name:MAGGIO
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 1:6886 NE WEST PORT MADISON RD
Mailing Address - Street 2:
Mailing Address - City:BAINBRIDGE ISLAND
Mailing Address - State:WA
Mailing Address - Zip Code:98110-1024
Mailing Address - Country:US
Mailing Address - Phone:206-715-0464
Mailing Address - Fax:
Practice Address - Street 1:5300 TALLMAN AVE
Practice Address - Street 2:OUTPATIENT REHAB SERVICES 1-SOUTH
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98107
Practice Address - Country:US
Practice Address - Phone:206-781-6346
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-10-31
Last Update Date:2018-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPT60169834225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist