Provider Demographics
NPI:1982026332
Name:BANKS, MARIANNE M (PHYSICAL THERAPIST)
Entity Type:Individual
Prefix:
First Name:MARIANNE
Middle Name:M
Last Name:BANKS
Suffix:
Gender:F
Credentials:PHYSICAL THERAPIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6121 PARKSIDE DR
Mailing Address - Street 2:
Mailing Address - City:ANACORTES
Mailing Address - State:WA
Mailing Address - Zip Code:98221-4007
Mailing Address - Country:US
Mailing Address - Phone:360-588-8830
Mailing Address - Fax:
Practice Address - Street 1:1040 SW KIMBALL DR
Practice Address - Street 2:
Practice Address - City:OAK HARBOR
Practice Address - State:WA
Practice Address - Zip Code:98277-7593
Practice Address - Country:US
Practice Address - Phone:360-675-8405
Practice Address - Fax:360-675-8405
Is Sole Proprietor?:Yes
Enumeration Date:2014-01-19
Last Update Date:2014-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPT00009573225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist