Provider Demographics
NPI:1396717518
Name:PERKINS, NANCY JEAN (PT)
Entity type:Individual
Prefix:
First Name:NANCY
Middle Name:JEAN
Last Name:PERKINS
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 1:28 E INDIANA AVE
Mailing Address - Street 2:
Mailing Address - City:SPOKANE
Mailing Address - State:WA
Mailing Address - Zip Code:99207-2314
Mailing Address - Country:US
Mailing Address - Phone:509-323-1494
Mailing Address - Fax:509-323-1503
Practice Address - Street 1:28 E INDIANA AVE
Practice Address - Street 2:
Practice Address - City:SPOKANE
Practice Address - State:WA
Practice Address - Zip Code:99207-2314
Practice Address - Country:US
Practice Address - Phone:509-323-1494
Practice Address - Fax:509-323-1503
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-02-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPT00003616225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA8344798Medicaid
WA8344798Medicaid