Provider Demographics
NPI:1023132321
Name:SAPIDA, CHARLENE WU (PT)
Entity type:Individual
Prefix:
First Name:CHARLENE
Middle Name:WU
Last Name:SAPIDA
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:CHARLENE
Other - Middle Name:
Other - Last Name:WU
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT
Mailing Address - Street 1:927 128TH ST SW # B
Mailing Address - Street 2:
Mailing Address - City:EVERETT
Mailing Address - State:WA
Mailing Address - Zip Code:98204-6315
Mailing Address - Country:US
Mailing Address - Phone:425-347-8614
Mailing Address - Fax:425-348-6986
Practice Address - Street 1:919 128TH ST SW
Practice Address - Street 2:
Practice Address - City:EVERETT
Practice Address - State:WA
Practice Address - Zip Code:98204-6315
Practice Address - Country:US
Practice Address - Phone:425-347-8614
Practice Address - Fax:425-348-6986
Is Sole Proprietor?:No
Enumeration Date:2007-03-19
Last Update Date:2013-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA32196225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist