Provider Demographics
NPI:1154305167
Name:RAY, SIGNIA A (PT)
Entity type:Individual
Prefix:
First Name:SIGNIA
Middle Name:A
Last Name:RAY
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:201 160TH ST S
Mailing Address - Street 2:SUITE 301
Mailing Address - City:SPANAWAY
Mailing Address - State:WA
Mailing Address - Zip Code:98387-8508
Mailing Address - Country:US
Mailing Address - Phone:253-531-4100
Mailing Address - Fax:253-531-3795
Practice Address - Street 1:201 160TH ST S
Practice Address - Street 2:SUITE 301
Practice Address - City:SPANAWAY
Practice Address - State:WA
Practice Address - Zip Code:98387-8508
Practice Address - Country:US
Practice Address - Phone:253-531-4100
Practice Address - Fax:253-531-3795
Is Sole Proprietor?:Yes
Enumeration Date:2005-12-02
Last Update Date:2010-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPT00002101225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA59041OtherSTATE OF WA WORKERS COMP
WARA2554OtherREGENCE BLUE SHIELD RIDER
WA8334328Medicaid
WA8334328Medicaid