Basic Information
| Provider Information | |||||||||
| NPI: | 1104933951 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | O'NEILL | ||||||||
| FirstName: | LANEY | ||||||||
| MiddleName: | VIRGINIA | ||||||||
| NamePrefix: | MRS. | ||||||||
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| Credential: | MPT | ||||||||
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| Mailing Information | |||||||||
| Address1: | 33650 6TH AVE S STE 100 | ||||||||
| Address2: | |||||||||
| City: | FEDERAL WAY | ||||||||
| State: | WA | ||||||||
| PostalCode: | 980036754 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2539423308 | ||||||||
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| Practice Location | |||||||||
| Address1: | 22659 PACIFIC HWY S | ||||||||
| Address2: | SUITE 201 | ||||||||
| City: | DES MOINES | ||||||||
| State: | WA | ||||||||
| PostalCode: | 981985155 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2068243668 | ||||||||
| FaxNumber: | 2068243964 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/25/2006 | ||||||||
| LastUpdateDate: | 07/29/2015 | ||||||||
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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 | 9074 | WA | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist |
No ID Information.