Basic Information
| Provider Information | |||||||||
| NPI: | 1669549895 | ||||||||
| EntityType: | 1 | ||||||||
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| LastName: | BALASH | ||||||||
| FirstName: | NANCY | ||||||||
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| Credential: | PT, DPT, OCS | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1101 MEADOWLARK LN | ||||||||
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| City: | ZILLAH | ||||||||
| State: | WA | ||||||||
| PostalCode: | 989539049 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5099856780 | ||||||||
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| Practice Location | |||||||||
| Address1: | 401 BUSTER RD | ||||||||
| Address2: | |||||||||
| City: | TOPPENISH | ||||||||
| State: | WA | ||||||||
| PostalCode: | 989489792 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5098652102 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 11/30/2006 | ||||||||
| LastUpdateDate: | 04/27/2015 | ||||||||
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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 | 1876 | AZ | N | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist | 225100000X | PT 60499274 | WA | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist |
No ID Information.