Provider Demographics
NPI:1255078663
Name:GRANT, NATALIE (PTA)
Entity type:Individual
Prefix:
First Name:NATALIE
Middle Name:
Last Name:GRANT
Suffix:
Gender:F
Credentials:PTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3818 LINDEN AVE N
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98103-8707
Mailing Address - Country:US
Mailing Address - Phone:612-859-8213
Mailing Address - Fax:
Practice Address - Street 1:1104 33RD AVE
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98122-5130
Practice Address - Country:US
Practice Address - Phone:937-469-4048
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-05-17
Last Update Date:2022-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant