Provider Demographics
NPI:1144633942
Name:HARMON, TAI (PT)
Entity type:Individual
Prefix:
First Name:TAI
Middle Name:
Last Name:HARMON
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1446 BISCUIT RIDGE RD
Mailing Address - Street 2:
Mailing Address - City:WAITSBURG
Mailing Address - State:WA
Mailing Address - Zip Code:99361-8736
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:420 SE MYRA RD
Practice Address - Street 2:
Practice Address - City:COLLEGE PLACE
Practice Address - State:WA
Practice Address - Zip Code:99324-1796
Practice Address - Country:US
Practice Address - Phone:509-529-4480
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-06-09
Last Update Date:2014-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPT 60039383225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist