Provider Demographics
NPI:1326001983
Name:DINGMAN, GRETCHEN (PT)
Entity type:Individual
Prefix:
First Name:GRETCHEN
Middle Name:
Last Name:DINGMAN
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1188 106TH AVE NE
Mailing Address - Street 2:SUITE 100
Mailing Address - City:BELLEVUE
Mailing Address - State:WA
Mailing Address - Zip Code:98004-8614
Mailing Address - Country:US
Mailing Address - Phone:425-454-4864
Mailing Address - Fax:425-646-3901
Practice Address - Street 1:901 BOREN AVE
Practice Address - Street 2:SUITE 410
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98104-3595
Practice Address - Country:US
Practice Address - Phone:206-447-1570
Practice Address - Fax:206-447-1592
Is Sole Proprietor?:No
Enumeration Date:2006-04-06
Last Update Date:2008-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPT00003049225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WAGAB19752Medicare PIN