| Doctor Name: | MISS SUMMER DENALI ICE-TSENG |
| NPI Number: | 1083802615 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | DPT |
| License Number: | PT00010754 |
| Business Practice Address: | 18120 Bothell Way Ne Ste A1 Bothell, WA - 980111943 |
| Business Phone Number: | 4254886640 |
| Business Fax Number: | 4254885424 |
| Mailing Address: | 18323 Bothell Everett Hwy Ste 220, BOTHELL |
| State: | WA |
| Postal Code: | 980125246 |
| Phone Number: | 4258065700 |
| Fax Number: | 4258065701 |
| NPI Enumeration Date: | 10/09/2007 |
| NPI Last Update Date: | 10/09/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 225100000X |
| License Number: | PT00010754 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | WA |
| Taxonomy Type: | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Taxonomy Classification: | Physical Therapist |
| Taxonomy Specialization: | |
| Taxonomy Definition: | (1) Physical therapists are health care professionals who evaluate and treat people with health problems resulting from injury or disease. PT |