Provider Demographics
NPI:1225731920
Name:WATAMURA, ASHLEY RAE (PT, DPT, PHD (C))
Entity type:Individual
Prefix:
First Name:ASHLEY
Middle Name:RAE
Last Name:WATAMURA
Suffix:
Gender:F
Credentials:PT, DPT, PHD (C)
Other - Prefix:
Other - First Name:ASHLEY
Other - Middle Name:W
Other - Last Name:HYATT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3971 LITTLE SAVANNAH HWY
Mailing Address - Street 2:228 HEALTH AND HUMAN SCIENCES BUILDING
Mailing Address - City:CULLOWHEE
Mailing Address - State:NC
Mailing Address - Zip Code:28723
Mailing Address - Country:US
Mailing Address - Phone:828-227-2296
Mailing Address - Fax:
Practice Address - Street 1:3971 LITTLE SAVANNAH RD SUITE 113
Practice Address - Street 2:
Practice Address - City:CULLOWHEE
Practice Address - State:NC
Practice Address - Zip Code:28723
Practice Address - Country:US
Practice Address - Phone:828-293-5174
Practice Address - Fax:828-293-0008
Is Sole Proprietor?:No
Enumeration Date:2023-03-23
Last Update Date:2024-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCP14076225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist