Provider Demographics
NPI:1477434595
Name:WELLSENIORS PT, PLLC
Entity type:Organization
Organization Name:WELLSENIORS PT, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER AND PHYSICAL THERAPIST
Authorized Official - Prefix:DR
Authorized Official - First Name:DAWNA
Authorized Official - Middle Name:SUE
Authorized Official - Last Name:FUQUA-WHITLEY
Authorized Official - Suffix:
Authorized Official - Credentials:PT, DPT
Authorized Official - Phone:425-471-1213
Mailing Address - Street 1:420 228TH ST SW APT B201
Mailing Address - Street 2:
Mailing Address - City:BOTHELL
Mailing Address - State:WA
Mailing Address - Zip Code:98021-9781
Mailing Address - Country:US
Mailing Address - Phone:425-471-1213
Mailing Address - Fax:
Practice Address - Street 1:420 228TH ST SW APT B201
Practice Address - Street 2:
Practice Address - City:BOTHELL
Practice Address - State:WA
Practice Address - Zip Code:98021-9781
Practice Address - Country:US
Practice Address - Phone:425-471-1213
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-09-08
Last Update Date:2025-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy