Provider Demographics
NPI:1457401978
Name:MCGREEVY, MARIANNE T
Entity Type:Individual
Prefix:
First Name:MARIANNE
Middle Name:T
Last Name:MCGREEVY
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 1:1035 NW NYE ST
Mailing Address - Street 2:
Mailing Address - City:PULLMAN
Mailing Address - State:WA
Mailing Address - Zip Code:99163-3428
Mailing Address - Country:US
Mailing Address - Phone:509-332-3325
Mailing Address - Fax:509-332-3819
Practice Address - Street 1:1035 NW NYE ST
Practice Address - Street 2:
Practice Address - City:PULLMAN
Practice Address - State:WA
Practice Address - Zip Code:99163-3428
Practice Address - Country:US
Practice Address - Phone:509-332-3325
Practice Address - Fax:509-332-3819
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-10
Last Update Date:2011-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPT000033350225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WAGAB18677OtherLEGACY PROVIDER #