Basic Information
| Provider Information | |||||||||
| NPI: | 1386066256 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | PEARSON-AAMODT | ||||||||
| FirstName: | LEANNE | ||||||||
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| Mailing Information | |||||||||
| Address1: | 3367 APPALOOSA WAY | ||||||||
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| City: | BREMERTON | ||||||||
| State: | WA | ||||||||
| PostalCode: | 983102117 | ||||||||
| CountryCode: | US | ||||||||
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| Practice Location | |||||||||
| Address1: | 2701 CLARE AVE | ||||||||
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| City: | BREMERTON | ||||||||
| State: | WA | ||||||||
| PostalCode: | 983103313 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3603773951 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 01/13/2014 | ||||||||
| LastUpdateDate: | 01/13/2014 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 225200000X | P160073332 | WA | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapy Assistant |
No ID Information.