Provider Demographics
NPI:1457792210
Name:FROST, MEREDITH MARIE (MS, ATC, LAT)
Entity Type:Individual
Prefix:
First Name:MEREDITH
Middle Name:MARIE
Last Name:FROST
Suffix:
Gender:F
Credentials:MS, ATC, LAT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1804 W UNION AVE
Mailing Address - Street 2:STE 101
Mailing Address - City:TACOMA
Mailing Address - State:WA
Mailing Address - Zip Code:98405-2062
Mailing Address - Country:US
Mailing Address - Phone:253-759-4036
Mailing Address - Fax:253-759-4341
Practice Address - Street 1:1804 W UNION AVE
Practice Address - Street 2:STE 101
Practice Address - City:TACOMA
Practice Address - State:WA
Practice Address - Zip Code:98405-2062
Practice Address - Country:US
Practice Address - Phone:253-759-4036
Practice Address - Fax:253-759-4341
Is Sole Proprietor?:No
Enumeration Date:2013-07-09
Last Update Date:2015-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAA1602344882255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer