Eileen Gwendolyn Petrie, CDPT
Student in an Organized Health Care Education/Training Program in Federal Way, WA. Individual provider (NPI-1).
NPI number1316572829
StatusActive
Last updated in NPPESMar 4, 2020
Details
- NPI
- 1316572829
- Entity type
- Individual (NPI-1)
- Name
- Eileen Gwendolyn Petrie
- Credential
- CDPT
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Mar 4, 2020
- Certification date
- Mar 4, 2020
- Last updated
- Mar 4, 2020
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 390200000X | Student in an Organized Health Care Education/Training Program | CO60371115 | WA | Yes |
Practice location
30620 Pacific Hwy S Ste 107Federal Way, WA 98003-4888
Phone 253-941-7555 · Fax 253-941-0652
Mailing address
30620 Pacific Hwy S Ste 107Federal Way, WA 98003-4888
Phone 253-941-7555 · Fax 253-941-0652
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This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.
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All 26 Student in an Organized Health Care Education/Training Program providers in Federal Way · All 3,475 providers in Federal Way
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