Provider Demographics
NPI:1619867892
Name:SIMMONS, MAGGIE (DPT)
Entity type:Individual
Prefix:DR
First Name:MAGGIE
Middle Name:
Last Name:SIMMONS
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2614 W NOB HILL BLVD STE A
Mailing Address - Street 2:
Mailing Address - City:YAKIMA
Mailing Address - State:WA
Mailing Address - Zip Code:98902-7506
Mailing Address - Country:US
Mailing Address - Phone:509-480-8041
Mailing Address - Fax:509-219-6002
Practice Address - Street 1:2614 W NOB HILL BLVD STE A
Practice Address - Street 2:
Practice Address - City:YAKIMA
Practice Address - State:WA
Practice Address - Zip Code:98902-7506
Practice Address - Country:US
Practice Address - Phone:509-480-8041
Practice Address - Fax:509-219-6002
Is Sole Proprietor?:No
Enumeration Date:2025-07-08
Last Update Date:2025-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPU61688417225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist