Provider Demographics
NPI:1023090149
Name:LEW, NATALIE BRENDA (PT)
Entity type:Individual
Prefix:
First Name:NATALIE
Middle Name:BRENDA
Last Name:LEW
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 1:12811 8TH AVE W
Mailing Address - Street 2:A-205
Mailing Address - City:EVERETT
Mailing Address - State:WA
Mailing Address - Zip Code:98204-6335
Mailing Address - Country:US
Mailing Address - Phone:425-348-1259
Mailing Address - Fax:425-348-3071
Practice Address - Street 1:12811 8TH AVE W
Practice Address - Street 2:A-205
Practice Address - City:EVERETT
Practice Address - State:WA
Practice Address - Zip Code:98204-6335
Practice Address - Country:US
Practice Address - Phone:425-348-1259
Practice Address - Fax:425-348-3071
Is Sole Proprietor?:No
Enumeration Date:2005-11-15
Last Update Date:2007-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPT000062972251X0800X
CAPT109032251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic
Provider Identifiers
StateIdentifier IDID TypeIssuer
WAAB29020GMedicare PIN