Provider Demographics
NPI:1396124384
Name:VAYNSHTEYN, EMILY RUTH
Entity type:Individual
Prefix:
First Name:EMILY
Middle Name:RUTH
Last Name:VAYNSHTEYN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9505 STEELE ST S
Mailing Address - Street 2:
Mailing Address - City:TACOMA
Mailing Address - State:WA
Mailing Address - Zip Code:98444-6858
Mailing Address - Country:US
Mailing Address - Phone:253-597-6800
Mailing Address - Fax:253-597-6888
Practice Address - Street 1:919 109TH AVE NE
Practice Address - Street 2:
Practice Address - City:BELLEVUE
Practice Address - State:WA
Practice Address - Zip Code:98004-4485
Practice Address - Country:US
Practice Address - Phone:425-531-7084
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-05-22
Last Update Date:2021-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPT 60385545225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist