| Doctor Name: | LAURA A IVERSON VON WULLERSTORFF |
| NPI Number: | 1366402158 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | PT |
| License Number: | PT00008484 |
| Business Practice Address: | 11800 Ne 128th Street Suite 400 Kirkland, WA - 980347208 |
| Business Phone Number: | 4258200869 |
| Business Fax Number: | 4258201745 |
| Mailing Address: | 1188 106th Ave Ne, Suite 100 BELLEVUE |
| State: | WA |
| Postal Code: | 980048614 |
| Phone Number: | 4254544864 |
| Fax Number: | 4256463901 |
| NPI Enumeration Date: | 03/24/2006 |
| NPI Last Update Date: | 05/16/2012 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 225100000X |
| License Number: | PT00008484 |
| 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 |