Provider Demographics
NPI:1316305543
Name:CANO, ABIGAIL (PT, DPT, CSCS)
Entity type:Individual
Prefix:
First Name:ABIGAIL
Middle Name:
Last Name:CANO
Suffix:
Gender:F
Credentials:PT, DPT, CSCS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4455 148TH AVE NE
Mailing Address - Street 2:
Mailing Address - City:BELLEVUE
Mailing Address - State:WA
Mailing Address - Zip Code:98007-3120
Mailing Address - Country:US
Mailing Address - Phone:425-869-4750
Mailing Address - Fax:
Practice Address - Street 1:9911 WILLOWS RD NE
Practice Address - Street 2:#100
Practice Address - City:REDMOND
Practice Address - State:WA
Practice Address - Zip Code:98052-1022
Practice Address - Country:US
Practice Address - Phone:425-869-4750
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-02-02
Last Update Date:2016-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA60611222225100000X
TX1227397225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist