Provider Demographics
NPI:1982804944
Name:BOWMAN, ALICIA LYNN (DPT)
Entity Type:Individual
Prefix:MRS
First Name:ALICIA
Middle Name:LYNN
Last Name:BOWMAN
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2210 S 10TH ST
Mailing Address - Street 2:
Mailing Address - City:TACOMA
Mailing Address - State:WA
Mailing Address - Zip Code:98405-3020
Mailing Address - Country:US
Mailing Address - Phone:360-970-1081
Mailing Address - Fax:
Practice Address - Street 1:2420 S UNION AVE STE 130
Practice Address - Street 2:
Practice Address - City:TACOMA
Practice Address - State:WA
Practice Address - Zip Code:98405-1306
Practice Address - Country:US
Practice Address - Phone:253-752-1070
Practice Address - Fax:253-752-2315
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-18
Last Update Date:2007-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPT00010585261QP2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy