Provider Demographics
NPI:1396213781
Name:REED, COURTNEY (PT)
Entity type:Individual
Prefix:
First Name:COURTNEY
Middle Name:
Last Name:REED
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 1:1515 S PACIFIC TECHNOLOGY BLVD
Mailing Address - Street 2:
Mailing Address - City:SPOKANE
Mailing Address - State:WA
Mailing Address - Zip Code:99224
Mailing Address - Country:US
Mailing Address - Phone:509-995-5146
Mailing Address - Fax:509-340-9942
Practice Address - Street 1:15920 E INDIANA AVE STE 101
Practice Address - Street 2:
Practice Address - City:SPOKANE VALLEY
Practice Address - State:WA
Practice Address - Zip Code:99216-6012
Practice Address - Country:US
Practice Address - Phone:509-209-7429
Practice Address - Fax:509-340-9942
Is Sole Proprietor?:No
Enumeration Date:2018-11-05
Last Update Date:2024-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
2251P0200X
WAPT60840439225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
No2251P0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
IDPT-9127OtherPT ID STATE LICENSE
VAPT60840439OtherPT WA ST LICENSE