Basic Information
| Provider Information | |||||||||
| NPI: | 1154472686 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | BISSON | ||||||||
| FirstName: | MAREN | ||||||||
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| Credential: | PT | ||||||||
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| Mailing Information | |||||||||
| Address1: | 3052 60TH AVE SW | ||||||||
| Address2: | |||||||||
| City: | SEATTLE | ||||||||
| State: | WA | ||||||||
| PostalCode: | 981162807 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2069229230 | ||||||||
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| Practice Location | |||||||||
| Address1: | 19820 SCRIBER LAKE RD | ||||||||
| Address2: | |||||||||
| City: | LYNNWOOD | ||||||||
| State: | WA | ||||||||
| PostalCode: | 980366121 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4256735220 | ||||||||
| FaxNumber: | 4256731597 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 01/12/2007 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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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 | PT00008045 | WA | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist |
No ID Information.