Provider Demographics
NPI:1962633826
Name:ZYGMUNTOWICZ, ELI (DPT)
Entity Type:Individual
Prefix:
First Name:ELI
Middle Name:
Last Name:ZYGMUNTOWICZ
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3800 WOODLAND PARK AVE N STE 100
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98103-7943
Mailing Address - Country:US
Mailing Address - Phone:206-284-2396
Mailing Address - Fax:206-547-9286
Practice Address - Street 1:3800 WOODLAND PARK AVE N STE 100
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98103-7943
Practice Address - Country:US
Practice Address - Phone:206-284-2396
Practice Address - Fax:206-547-9286
Is Sole Proprietor?:No
Enumeration Date:2009-07-27
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPT60095182225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist