Provider Demographics
NPI:1942415518
Name:AMOROSI, SUSAN C (PT)
Entity Type:Individual
Prefix:
First Name:SUSAN
Middle Name:C
Last Name:AMOROSI
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 1:1100 9TH AVE
Mailing Address - Street 2:MS:M4-PFS
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98101-2756
Mailing Address - Country:US
Mailing Address - Phone:206-515-5811
Mailing Address - Fax:
Practice Address - Street 1:222 112TH AVE NE STE 101
Practice Address - Street 2:
Practice Address - City:BELLEVUE
Practice Address - State:WA
Practice Address - Zip Code:98004-5856
Practice Address - Country:US
Practice Address - Phone:425-637-1855
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-14
Last Update Date:2015-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPT00003581225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WAUS2296666OtherAETNA SPECIALIST PIN
WAAM1277OtherBLUE SHIELD#
WA0039585OtherLABOR AND INDUSTRIES#
WA8343188Medicaid
WAUS2296666OtherAETNA SPECIALIST PIN
WA8804983Medicare PIN