Provider Demographics
NPI:1184448847
Name:RICE, SOPHIA (PT, DPT)
Entity type:Individual
Prefix:
First Name:SOPHIA
Middle Name:
Last Name:RICE
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4201 NE 66TH AVE STE 104
Mailing Address - Street 2:
Mailing Address - City:VANCOUVER
Mailing Address - State:WA
Mailing Address - Zip Code:98661-3078
Mailing Address - Country:US
Mailing Address - Phone:360-258-1637
Mailing Address - Fax:
Practice Address - Street 1:4201 NE 66TH AVE STE 104
Practice Address - Street 2:
Practice Address - City:VANCOUVER
Practice Address - State:WA
Practice Address - Zip Code:98661-3078
Practice Address - Country:US
Practice Address - Phone:360-258-1637
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-11-11
Last Update Date:2024-11-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA61564051225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist