Provider Demographics
NPI:1912094731
Name:LETTER, LAURIE ANN (PT, LMP)
Entity Type:Individual
Prefix:
First Name:LAURIE
Middle Name:ANN
Last Name:LETTER
Suffix:
Gender:F
Credentials:PT, LMP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 454
Mailing Address - Street 2:
Mailing Address - City:INDIANOLA
Mailing Address - State:WA
Mailing Address - Zip Code:98342-0454
Mailing Address - Country:US
Mailing Address - Phone:206-715-7131
Mailing Address - Fax:360-297-3437
Practice Address - Street 1:219 MADISON AVE S
Practice Address - Street 2:
Practice Address - City:BAINBRIDGE ISLAND
Practice Address - State:WA
Practice Address - Zip Code:98110-2503
Practice Address - Country:US
Practice Address - Phone:206-715-7131
Practice Address - Fax:360-297-3437
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPT00002394225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist