Provider Demographics
NPI:1013990092
Name:HANIK, PEGGY (PT)
Entity type:Individual
Prefix:MRS
First Name:PEGGY
Middle Name:
Last Name:HANIK
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 1:13512 NE 238TH WAY
Mailing Address - Street 2:
Mailing Address - City:BATTLE GROUND
Mailing Address - State:WA
Mailing Address - Zip Code:98604-4792
Mailing Address - Country:US
Mailing Address - Phone:360-702-6494
Mailing Address - Fax:
Practice Address - Street 1:1207 SE RASMUSSEN BLVD STE 115
Practice Address - Street 2:
Practice Address - City:BATTLE GROUND
Practice Address - State:WA
Practice Address - Zip Code:98604-8618
Practice Address - Country:US
Practice Address - Phone:360-702-6494
Practice Address - Fax:360-984-5845
Is Sole Proprietor?:No
Enumeration Date:2005-11-23
Last Update Date:2024-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPT9154225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist