Provider Demographics
NPI:1003947854
Name:RUE, WENDOLYN ANNE (PT)
Entity type:Individual
Prefix:MS
First Name:WENDOLYN
Middle Name:ANNE
Last Name:RUE
Suffix:
Gender:
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:785 SE BAYSHORE DR. SUITE 102
Mailing Address - Street 2:
Mailing Address - City:OAK HARBOR
Mailing Address - State:WA
Mailing Address - Zip Code:98277-4062
Mailing Address - Country:US
Mailing Address - Phone:360-279-8323
Mailing Address - Fax:360-279-8772
Practice Address - Street 1:5197 ANGLERS HAVEN DR
Practice Address - Street 2:
Practice Address - City:OAK HARBOR
Practice Address - State:WA
Practice Address - Zip Code:98277-9607
Practice Address - Country:US
Practice Address - Phone:360-421-2852
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-07
Last Update Date:2025-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPT00006648174400000X
WA00006648225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
No174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA0189569OtherLABOR AND INDUSTRIES
WA0189569OtherLABOR AND INDUSTRIES