Doctor Name: | MARY MICHELLE MANZON |
NPI Number: | 1639588791 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | |
License Number: | PT00010405 |
Business Practice Address: | 9901 272nd Pl Nw Stanwood, WA - 982927449 |
Business Phone Number: | 3606292126 |
Business Fax Number: | |
Mailing Address: | 25117 Sw Parkway Ave Ste D, WILSONVILLE |
State: | OR |
Postal Code: | 970709697 |
Phone Number: | |
Fax Number: | |
NPI Enumeration Date: | 08/03/2014 |
NPI Last Update Date: | 08/03/2014 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 225100000X |
License Number: | PT00010405 |
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 |