Provider Demographics
NPI:1427490911
Name:SORENSEN, TOVE LISE (PT)
Entity type:Individual
Prefix:
First Name:TOVE
Middle Name:LISE
Last Name:SORENSEN
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 1:1035 116TH AVE NE
Mailing Address - Street 2:IP PHYSICAL THERAPY
Mailing Address - City:BELLEVUE
Mailing Address - State:WA
Mailing Address - Zip Code:98004-4604
Mailing Address - Country:US
Mailing Address - Phone:425-688-5868
Mailing Address - Fax:425-688-5145
Practice Address - Street 1:1417 116TH AVE NE
Practice Address - Street 2:STE 110
Practice Address - City:BELLEVUE
Practice Address - State:WA
Practice Address - Zip Code:98004-3821
Practice Address - Country:US
Practice Address - Phone:425-688-5868
Practice Address - Fax:425-688-5145
Is Sole Proprietor?:Yes
Enumeration Date:2013-07-24
Last Update Date:2013-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPT00006200225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist