Provider Demographics
NPI:1699178392
Name:SONG, ROSEMARY E (PT, DPT)
Entity type:Individual
Prefix:DR
First Name:ROSEMARY
Middle Name:E
Last Name:SONG
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:ROSEMARY
Other - Middle Name:E
Other - Last Name:POTTS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT, DPT
Mailing Address - Street 1:21400 72ND AVE W
Mailing Address - Street 2:
Mailing Address - City:EDMONDS
Mailing Address - State:WA
Mailing Address - Zip Code:98026-7702
Mailing Address - Country:US
Mailing Address - Phone:425-608-2532
Mailing Address - Fax:425-771-0116
Practice Address - Street 1:21601 76TH AVE W
Practice Address - Street 2:
Practice Address - City:EDMONDS
Practice Address - State:WA
Practice Address - Zip Code:98026-7507
Practice Address - Country:US
Practice Address - Phone:425-640-4140
Practice Address - Fax:425-640-4141
Is Sole Proprietor?:No
Enumeration Date:2014-10-08
Last Update Date:2024-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPT 60469962225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist