Provider Demographics
NPI:1316477516
Name:GATMAYTAN, GINA RENATA (DPT)
Entity type:Individual
Prefix:
First Name:GINA
Middle Name:RENATA
Last Name:GATMAYTAN
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:GINA
Other - Middle Name:MARIE
Other - Last Name:PETERSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:16300 AURORA AVE N STE A
Mailing Address - Street 2:
Mailing Address - City:SHORELINE
Mailing Address - State:WA
Mailing Address - Zip Code:98133-2602
Mailing Address - Country:US
Mailing Address - Phone:206-552-9201
Mailing Address - Fax:206-590-5914
Practice Address - Street 1:16300 AURORA AVE N STE A
Practice Address - Street 2:
Practice Address - City:SHORELINE
Practice Address - State:WA
Practice Address - Zip Code:98133-2602
Practice Address - Country:US
Practice Address - Phone:425-923-8441
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-06-20
Last Update Date:2023-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPT60743687225100000X, 2251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic
No225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist