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NPI Code Detail

MEDICARE: DOUGLAS PAUL RIBECA P.T.

MEDICARE: DOUGLAS PAUL RIBECA P.T.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1225100000XPhysical TherapistPT00010682WA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1PT00010682OTHERWAWASHINGTON STATE DEPARTMENT OF HEALTH

General Provider Information

NPI Number : 1215926464
Entity Type Code : Individual
Provider Name (Legal Business Name) : DOUGLAS PAUL RIBECA P.T.
Provider Business Mailing Address
First Line : 66 POINT FOSDICK DR NW
Second Line :
City : GIG HARBOR
State : WA
Zip : 98335-7866
Country : US
Telephone Number : 253-509-0566
Fax Number :
Provider Business Practice Location Address
First Line : 315 MARTIN LUTHER KING JR WAY
Second Line :
City : TACOMA
State : WA
Zip : 98405-4234
Country : US
Telephone Number : 253-459-6999
Fax Number : 253-459-6980
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/20/2005
Last Update Date : 05/05/2011

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