Provider Demographics
NPI:1952572760
Name:GREGORY, AMANDA WHITNEY (PT)
Entity Type:Individual
Prefix:
First Name:AMANDA
Middle Name:WHITNEY
Last Name:GREGORY
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:UNIVERSITY OF WASHINGTON - HARING CENTER
Mailing Address - Street 2:PO BOX 357925
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98195-7925
Mailing Address - Country:US
Mailing Address - Phone:206-543-4011
Mailing Address - Fax:
Practice Address - Street 1:UNIVERSITY OF WASHINGTON - HARING CENTER
Practice Address - Street 2:PO BOX 357925
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98195-7925
Practice Address - Country:US
Practice Address - Phone:206-543-4011
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-03-19
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPT00010565225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist