Basic Information
| Provider Information | |||||||||
| NPI: | 1528638665 | ||||||||
| EntityType: | 1 | ||||||||
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| LastName: | TAM | ||||||||
| FirstName: | SYLVIA | ||||||||
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| Credential: | PT, DPT | ||||||||
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| Mailing Information | |||||||||
| Address1: | 3257 FUHRMAN AVE E APT A | ||||||||
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| City: | SEATTLE | ||||||||
| State: | WA | ||||||||
| PostalCode: | 981023877 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4152154435 | ||||||||
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| Practice Location | |||||||||
| Address1: | 11511 NE 10TH ST # 3A | ||||||||
| Address2: | |||||||||
| City: | BELLEVUE | ||||||||
| State: | WA | ||||||||
| PostalCode: | 980048578 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4255023000 | ||||||||
| FaxNumber: | 8446201839 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/30/2021 | ||||||||
| LastUpdateDate: | 10/26/2022 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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| NPICertificationDate: | 10/26/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 225100000X | PT60770818 | WA | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist |
No ID Information.