Provider Demographics
NPI:1699374942
Name:GUILLEN, LAYLA A (PT DPT)
Entity type:Individual
Prefix:
First Name:LAYLA
Middle Name:A
Last Name:GUILLEN
Suffix:
Gender:F
Credentials:PT DPT
Other - Prefix:
Other - First Name:LAYLA
Other - Middle Name:A
Other - Last Name:ZAHNISER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1550 NE RIDDELL RD STE 170
Mailing Address - Street 2:
Mailing Address - City:BREMERTON
Mailing Address - State:WA
Mailing Address - Zip Code:98310-3060
Mailing Address - Country:US
Mailing Address - Phone:360-474-3274
Mailing Address - Fax:360-824-6720
Practice Address - Street 1:1550 NE RIDDELL RD STE 170
Practice Address - Street 2:
Practice Address - City:BREMERTON
Practice Address - State:WA
Practice Address - Zip Code:98310-3060
Practice Address - Country:US
Practice Address - Phone:360-474-3274
Practice Address - Fax:360-824-6720
Is Sole Proprietor?:No
Enumeration Date:2020-10-19
Last Update Date:2021-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA61103475225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist