Provider Demographics
NPI:1154998367
Name:TEJERA, ELLEN MARIE COOPER (PT DPT)
Entity type:Individual
Prefix:
First Name:ELLEN
Middle Name:MARIE COOPER
Last Name:TEJERA
Suffix:
Gender:F
Credentials:PT DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8514 NE 137TH PL
Mailing Address - Street 2:
Mailing Address - City:KIRKLAND
Mailing Address - State:WA
Mailing Address - Zip Code:98034-1716
Mailing Address - Country:US
Mailing Address - Phone:360-701-9910
Mailing Address - Fax:
Practice Address - Street 1:7525 166TH AVE NE STE D225
Practice Address - Street 2:
Practice Address - City:REDMOND
Practice Address - State:WA
Practice Address - Zip Code:98052-7828
Practice Address - Country:US
Practice Address - Phone:425-437-2044
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-06-07
Last Update Date:2021-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist