Provider Demographics
NPI:1053169466
Name:GUTHRIE, CONNOR (DPT)
Entity type:Individual
Prefix:
First Name:CONNOR
Middle Name:
Last Name:GUTHRIE
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:24719 59TH AVE NE
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:WA
Mailing Address - Zip Code:98223-9782
Mailing Address - Country:US
Mailing Address - Phone:425-308-5437
Mailing Address - Fax:425-962-9449
Practice Address - Street 1:24719 59TH AVE NE
Practice Address - Street 2:
Practice Address - City:ARLINGTON
Practice Address - State:WA
Practice Address - Zip Code:98223-9782
Practice Address - Country:US
Practice Address - Phone:360-588-4145
Practice Address - Fax:425-962-9449
Is Sole Proprietor?:Yes
Enumeration Date:2024-05-09
Last Update Date:2024-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist