Provider Demographics
NPI:1386427177
Name:CHANFRAU, TINA MARIE BELGARDE (DPT)
Entity type:Individual
Prefix:
First Name:TINA
Middle Name:MARIE BELGARDE
Last Name:CHANFRAU
Suffix:
Gender:
Credentials:DPT
Other - Prefix:
Other - First Name:TINA
Other - Middle Name:MARIE
Other - Last Name:BELGARDE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:7616 19TH ST W
Mailing Address - Street 2:
Mailing Address - City:TACOMA
Mailing Address - State:WA
Mailing Address - Zip Code:98466-3615
Mailing Address - Country:US
Mailing Address - Phone:253-433-5609
Mailing Address - Fax:
Practice Address - Street 1:2711 N 21ST ST
Practice Address - Street 2:
Practice Address - City:TACOMA
Practice Address - State:WA
Practice Address - Zip Code:98406-7519
Practice Address - Country:US
Practice Address - Phone:253-433-5609
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-08-15
Last Update Date:2025-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPT61474246225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist