Provider Demographics
NPI:1881703528
Name:CRAIG, LINDA S (PT)
Entity type:Individual
Prefix:
First Name:LINDA
Middle Name:S
Last Name:CRAIG
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:LINDA
Other - Middle Name:S
Other - Last Name:PLATTER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT
Mailing Address - Street 1:6007 119TH AVE E
Mailing Address - Street 2:
Mailing Address - City:PUYALLUP
Mailing Address - State:WA
Mailing Address - Zip Code:98372-2830
Mailing Address - Country:US
Mailing Address - Phone:253-848-9769
Mailing Address - Fax:253-445-1250
Practice Address - Street 1:6007 119TH AVE E
Practice Address - Street 2:
Practice Address - City:PUYALLUP
Practice Address - State:WA
Practice Address - Zip Code:98372-2830
Practice Address - Country:US
Practice Address - Phone:253-848-9769
Practice Address - Fax:253-445-1250
Is Sole Proprietor?:No
Enumeration Date:2006-08-29
Last Update Date:2012-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPT00004074174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA0117297OtherDEPARTMENT OF LABOR AND INDUSTRIES
WA0117297OtherDEPARTMENT OF LABOR AND INDUSTRIES
WAS40034Medicare UPIN