Provider Demographics
NPI:1821059221
Name:SCHERB, ELISA (PT)
Entity Type:Individual
Prefix:
First Name:ELISA
Middle Name:
Last Name:SCHERB
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4649 SUNNYSIDE AVE N
Mailing Address - Street 2:SUITE 302
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98103-6900
Mailing Address - Country:US
Mailing Address - Phone:206-588-0855
Mailing Address - Fax:206-588-0397
Practice Address - Street 1:4649 SUNNYSIDE AVE N
Practice Address - Street 2:SUITE 302
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98103-6900
Practice Address - Country:US
Practice Address - Phone:206-588-0855
Practice Address - Fax:206-588-0397
Is Sole Proprietor?:No
Enumeration Date:2006-03-28
Last Update Date:2012-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPT00010002225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA8444820Medicaid
WA8444820Medicaid
WAG8895551Medicare PIN