Provider Demographics
NPI:1881641942
Name:MAZZAFERRO-KNOWLES, SUSAN (PT)
Entity Type:Individual
Prefix:
First Name:SUSAN
Middle Name:
Last Name:MAZZAFERRO-KNOWLES
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 1:3005 ALDERWOOD MALL PKWY
Mailing Address - Street 2:STE 100
Mailing Address - City:LYNNWOOD
Mailing Address - State:WA
Mailing Address - Zip Code:98036-6921
Mailing Address - Country:US
Mailing Address - Phone:206-979-1413
Mailing Address - Fax:425-771-2425
Practice Address - Street 1:3005 ALDERWOOD MALL PKWY
Practice Address - Street 2:STE 100
Practice Address - City:LYNNWOOD
Practice Address - State:WA
Practice Address - Zip Code:98036-6921
Practice Address - Country:US
Practice Address - Phone:206-979-1413
Practice Address - Fax:425-771-2425
Is Sole Proprietor?:No
Enumeration Date:2006-05-27
Last Update Date:2020-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPT00005338225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist