Provider Demographics
NPI:1750436440
Name:MERRITT, CHRISTINE ELEANOR (PT, CST)
Entity type:Individual
Prefix:
First Name:CHRISTINE
Middle Name:ELEANOR
Last Name:MERRITT
Suffix:
Gender:F
Credentials:PT, CST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:625 4TH AVE
Mailing Address - Street 2:SUITE 303
Mailing Address - City:KIRKLAND
Mailing Address - State:WA
Mailing Address - Zip Code:98033-9028
Mailing Address - Country:US
Mailing Address - Phone:425-828-0802
Mailing Address - Fax:425-485-8749
Practice Address - Street 1:625 4TH AVE
Practice Address - Street 2:SUITE 303
Practice Address - City:KIRKLAND
Practice Address - State:WA
Practice Address - Zip Code:98033-9028
Practice Address - Country:US
Practice Address - Phone:425-828-0802
Practice Address - Fax:425-485-8749
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPT00002916225100000X
CAPT5923225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist