Provider Demographics
NPI:1861950263
Name:SPRINGER, GLENDA RAE (MSPT)
Entity type:Individual
Prefix:
First Name:GLENDA
Middle Name:RAE
Last Name:SPRINGER
Suffix:
Gender:F
Credentials:MSPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7820 W 6TH AVE
Mailing Address - Street 2:
Mailing Address - City:KENNEWICK
Mailing Address - State:WA
Mailing Address - Zip Code:99336-9447
Mailing Address - Country:US
Mailing Address - Phone:509-783-5282
Mailing Address - Fax:
Practice Address - Street 1:7820 W 6TH AVE
Practice Address - Street 2:
Practice Address - City:KENNEWICK
Practice Address - State:WA
Practice Address - Zip Code:99336-9447
Practice Address - Country:US
Practice Address - Phone:509-783-5282
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-03-05
Last Update Date:2019-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA00007843225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist