Basic Information
| Provider Information | |||||||||
| NPI: | 1083160022 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | MOLYNEUX-ELLIOT | ||||||||
| FirstName: | THOMAS | ||||||||
| MiddleName: | HENRY | ||||||||
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| Credential: | DPT | ||||||||
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| Mailing Information | |||||||||
| Address1: | 3303 E K ST | ||||||||
| Address2: | |||||||||
| City: | TACOMA | ||||||||
| State: | WA | ||||||||
| PostalCode: | 984043233 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4254440861 | ||||||||
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| Practice Location | |||||||||
| Address1: | 3315 S 23RD ST STE 210 | ||||||||
| Address2: | |||||||||
| City: | TACOMA | ||||||||
| State: | WA | ||||||||
| PostalCode: | 984051616 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2532317070 | ||||||||
| FaxNumber: | 2532840450 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/30/2016 | ||||||||
| LastUpdateDate: | 09/29/2019 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 225100000X | PT60650077 | WA | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist |
No ID Information.