Provider Demographics
NPI:1649735291
Name:HARRISON, VICTORIA (DPT)
Entity type:Individual
Prefix:
First Name:VICTORIA
Middle Name:
Last Name:HARRISON
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1215 4TH AVE STE 1000
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98161-1017
Mailing Address - Country:US
Mailing Address - Phone:206-622-9001
Mailing Address - Fax:206-622-4311
Practice Address - Street 1:1215 4TH AVE STE 1000
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98161-1017
Practice Address - Country:US
Practice Address - Phone:206-622-9001
Practice Address - Fax:206-622-4311
Is Sole Proprietor?:No
Enumeration Date:2019-02-07
Last Update Date:2021-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ME5298225100000X
NY04393225100000X
WAPT60963439225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist