Provider Demographics
NPI:1750834487
Name:CALLAGHAN, BLAIR (PT, DPT)
Entity type:Individual
Prefix:DR
First Name:BLAIR
Middle Name:
Last Name:CALLAGHAN
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 1:7900 E GREEN LAKE DR N STE 204
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98103-4819
Mailing Address - Country:US
Mailing Address - Phone:206-985-2236
Mailing Address - Fax:202-347-2375
Practice Address - Street 1:7900 E GREEN LAKE DR N STE 204
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98103-4819
Practice Address - Country:US
Practice Address - Phone:206-985-2236
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-07-29
Last Update Date:2024-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCPT8719812251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic
Provider Identifiers
StateIdentifier IDID TypeIssuer
DCPT871981OtherLICENSE
1750834487OtherNPI