Provider Demographics
NPI:1316900970
Name:MENTING, VIRGINIA D (PT)
Entity type:Individual
Prefix:
First Name:VIRGINIA
Middle Name:D
Last Name:MENTING
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:VIRGINIA
Other - Middle Name:
Other - Last Name:DOOLEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT
Mailing Address - Street 1:1560 140TH AVE NE
Mailing Address - Street 2:SUITE 100
Mailing Address - City:BELLEVUE
Mailing Address - State:WA
Mailing Address - Zip Code:98005-4571
Mailing Address - Country:US
Mailing Address - Phone:425-746-2475
Mailing Address - Fax:425-746-2471
Practice Address - Street 1:22500 SE 64TH PL
Practice Address - Street 2:BUILDING G, SUITE 115
Practice Address - City:ISSAQUAH
Practice Address - State:WA
Practice Address - Zip Code:98027-8111
Practice Address - Country:US
Practice Address - Phone:425-441-6075
Practice Address - Fax:425-746-2471
Is Sole Proprietor?:No
Enumeration Date:2006-04-06
Last Update Date:2016-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPT00007951225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WAG8936185Medicare PIN