Provider Demographics
NPI:1700926375
Name:FOWLER, JANET CHEN (MPT)
Entity type:Individual
Prefix:
First Name:JANET
Middle Name:CHEN
Last Name:FOWLER
Suffix:
Gender:F
Credentials:MPT
Other - Prefix:
Other - First Name:JANET
Other - Middle Name:C
Other - Last Name:CHEN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MPT
Mailing Address - Street 1:10505 19TH AVE SE
Mailing Address - Street 2:SUITE B
Mailing Address - City:EVERETT
Mailing Address - State:WA
Mailing Address - Zip Code:98208-4280
Mailing Address - Country:US
Mailing Address - Phone:408-570-0510
Mailing Address - Fax:408-945-4018
Practice Address - Street 1:10511 19TH AVE SE STE B
Practice Address - Street 2:
Practice Address - City:EVERETT
Practice Address - State:WA
Practice Address - Zip Code:98208-4279
Practice Address - Country:US
Practice Address - Phone:425-357-8885
Practice Address - Fax:425-357-8454
Is Sole Proprietor?:No
Enumeration Date:2007-02-06
Last Update Date:2013-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPT00007824225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA8373862Medicaid
WA8373862Medicaid