Basic Information
| Provider Information | |||||||||
| NPI: | 1689199309 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | SUMNER | ||||||||
| FirstName: | ERICA | ||||||||
| MiddleName: | MICHELLE | ||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | PT, DPT | ||||||||
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| Mailing Information | |||||||||
| Address1: | 33650 6TH AVE S | ||||||||
| Address2: | STE 100 | ||||||||
| City: | FEDERAL WAY | ||||||||
| State: | WA | ||||||||
| PostalCode: | 980036754 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2539423308 | ||||||||
| FaxNumber: | 2532370643 | ||||||||
| Practice Location | |||||||||
| Address1: | 10000 W 75TH ST STE 250 | ||||||||
| Address2: | |||||||||
| City: | MERRIAM | ||||||||
| State: | KS | ||||||||
| PostalCode: | 662042218 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8889131910 | ||||||||
| FaxNumber: | 8779131174 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/03/2017 | ||||||||
| LastUpdateDate: | 07/10/2018 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 225100000X | PT60763992 | WA | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist |
No ID Information.