Provider Demographics
NPI:1821311770
Name:LASKEY, SAMANTHA MEHAFFEY (PT)
Entity Type:Individual
Prefix:
First Name:SAMANTHA
Middle Name:MEHAFFEY
Last Name:LASKEY
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 1:3009 STATE ROUTE 153
Mailing Address - Street 2:
Mailing Address - City:TWISP
Mailing Address - State:WA
Mailing Address - Zip Code:98856-9622
Mailing Address - Country:US
Mailing Address - Phone:360-961-7262
Mailing Address - Fax:
Practice Address - Street 1:3009 STATE ROUTE 153
Practice Address - Street 2:
Practice Address - City:TWISP
Practice Address - State:WA
Practice Address - Zip Code:98856-9622
Practice Address - Country:US
Practice Address - Phone:360-961-7262
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-03-07
Last Update Date:2020-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA60132785225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist