Basic Information
| Provider Information | |||||||||
| NPI: | 1982079208 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | FRIEDMAN | ||||||||
| FirstName: | MARY | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1830 BICKFORD AVE STE 209 | ||||||||
| Address2: | |||||||||
| City: | SNOHOMISH | ||||||||
| State: | WA | ||||||||
| PostalCode: | 982901750 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3605687774 | ||||||||
| FaxNumber: | 3605687779 | ||||||||
| Practice Location | |||||||||
| Address1: | 1830 BICKFORD AVE STE 209 | ||||||||
| Address2: | |||||||||
| City: | SNOHOMISH | ||||||||
| State: | WA | ||||||||
| PostalCode: | 982901750 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3605687774 | ||||||||
| FaxNumber: | 3605687779 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 12/11/2015 | ||||||||
| LastUpdateDate: | 06/11/2021 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 06/11/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 225100000X | PT00010785 | WA | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist |
No ID Information.