Provider Demographics
NPI:1962626168
Name:OSBORNE, CATHERINE SUSAN (PT)
Entity Type:Individual
Prefix:MS
First Name:CATHERINE
Middle Name:SUSAN
Last Name:OSBORNE
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:PO BOX 60241
Mailing Address - Street 2:CHESAW WEST
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98160-0241
Mailing Address - Country:US
Mailing Address - Phone:206-546-0249
Mailing Address - Fax:206-533-8719
Practice Address - Street 1:835 NW 190TH ST
Practice Address - Street 2:
Practice Address - City:SHORELINE
Practice Address - State:WA
Practice Address - Zip Code:98177-2626
Practice Address - Country:US
Practice Address - Phone:206-546-0249
Practice Address - Fax:206-533-8719
Is Sole Proprietor?:No
Enumeration Date:2007-04-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPT00001031225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
Q47851Medicare UPIN
8854564Medicare ID - Type Unspecified