Provider Demographics
NPI:1649521378
Name:TORTORELLI, ALIS MARIE (PT, DPT)
Entity type:Individual
Prefix:MISS
First Name:ALIS
Middle Name:MARIE
Last Name:TORTORELLI
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3900 DEEMER RD
Mailing Address - Street 2:#308
Mailing Address - City:BELLINGHAM
Mailing Address - State:WA
Mailing Address - Zip Code:98226-8035
Mailing Address - Country:US
Mailing Address - Phone:509-939-1521
Mailing Address - Fax:
Practice Address - Street 1:2001 H ST
Practice Address - Street 2:
Practice Address - City:BELLINGHAM
Practice Address - State:WA
Practice Address - Zip Code:98225-3226
Practice Address - Country:US
Practice Address - Phone:360-671-3660
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-09-20
Last Update Date:2012-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPT 60295371225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist