Provider Demographics
NPI:1912081035
Name:GREEN, LINDA WASHBURN (PHYSICAL THERAPIST)
Entity type:Individual
Prefix:MRS
First Name:LINDA
Middle Name:WASHBURN
Last Name:GREEN
Suffix:
Gender:F
Credentials:PHYSICAL THERAPIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:127 SYLVESTOR PLACE
Mailing Address - Street 2:
Mailing Address - City:HIGHLANDS RANCH
Mailing Address - State:CO
Mailing Address - Zip Code:80129-6204
Mailing Address - Country:US
Mailing Address - Phone:303-791-5779
Mailing Address - Fax:
Practice Address - Street 1:10717 JORDAN COURT
Practice Address - Street 2:THERAPY CONSULTANTS
Practice Address - City:PARKER
Practice Address - State:CO
Practice Address - Zip Code:80134
Practice Address - Country:US
Practice Address - Phone:303-840-6494
Practice Address - Fax:303-805-0602
Is Sole Proprietor?:No
Enumeration Date:2006-10-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
C521428Medicare ID - Type Unspecified