| Doctor Name: | ELENA SUZANNE WACK |
| NPI Number: | 1104241728 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | DPT |
| License Number: | PT60421494 |
| Business Practice Address: | 9514 Gravelly Lake Dr Sw Lakewood, WA - 984991514 |
| Business Phone Number: | 2539839395 |
| Business Fax Number: | |
| Mailing Address: | 9315 Gravelly Lake Dr Sw, Suite 306 LAKEWOOD |
| State: | WA |
| Postal Code: | 984991574 |
| Phone Number: | 2535815200 |
| Fax Number: | 2535815203 |
| NPI Enumeration Date: | 02/19/2014 |
| NPI Last Update Date: | 02/19/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 225100000X |
| License Number: | PT60421494 |
| 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 |