| Doctor Name: | MS. JUDITH I WALLER |
| NPI Number: | 1245398023 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | PT |
| License Number: | PT00002638 |
| Business Practice Address: | 981 Powell Ave Sw 130 Renton, WA - 980572990 |
| Business Phone Number: | 2064390449 |
| Business Fax Number: | 2062443783 |
| Mailing Address: | 330 Sw 43rd St, Suite K, Pmb 117 RENTON |
| State: | WA |
| Postal Code: | 980574900 |
| Phone Number: | 2064390499 |
| Fax Number: | 2062443783 |
| NPI Enumeration Date: | 12/05/2006 |
| NPI Last Update Date: | 01/31/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 225100000X |
| License Number: | PT00002638 |
| 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 |