Provider Demographics
NPI:1912450347
Name:MERKLING, STACEY (PT, DPT)
Entity type:Individual
Prefix:
First Name:STACEY
Middle Name:
Last Name:MERKLING
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:22526 SE 64TH PL
Mailing Address - Street 2:SUITE 140
Mailing Address - City:ISSAQUAH
Mailing Address - State:WA
Mailing Address - Zip Code:98027-5368
Mailing Address - Country:US
Mailing Address - Phone:425-830-0028
Mailing Address - Fax:
Practice Address - Street 1:22526 SE 64TH PL
Practice Address - Street 2:SUITE 140
Practice Address - City:ISSAQUAH
Practice Address - State:WA
Practice Address - Zip Code:98027-5368
Practice Address - Country:US
Practice Address - Phone:425-830-0028
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-08-02
Last Update Date:2018-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPT60630287225100000X, 2251P0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251P0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistPediatrics
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist