Basic Information
| Provider Information | |||||||||
| NPI: | 1013294552 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | GOLDSTEIN | ||||||||
| FirstName: | HANNAH | ||||||||
| MiddleName: | L | ||||||||
| NamePrefix: | MS. | ||||||||
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| Credential: | DPT | ||||||||
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| Mailing Information | |||||||||
| Address1: | 3000 LIMITED LN NW | ||||||||
| Address2: | STE 100 | ||||||||
| City: | OLYMPIA | ||||||||
| State: | WA | ||||||||
| PostalCode: | 985022704 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3602927245 | ||||||||
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| Practice Location | |||||||||
| Address1: | 5006 CENTER ST | ||||||||
| Address2: | STE N | ||||||||
| City: | TACOMA | ||||||||
| State: | WA | ||||||||
| PostalCode: | 984092314 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2534760449 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 11/11/2011 | ||||||||
| LastUpdateDate: | 11/11/2011 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 225100000X | PT60247651 | WA | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist | 2251N0400X | PT60247651 | WA | N | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist | Neurology | 2251P0200X | PT60247651 | WA | N | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist | Pediatrics |
No ID Information.