MEDICARE: DR. ERICK KAMEYOSHI HARADA PT, DPT

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
1	225100000X	Physical Therapist	PT60103910	WA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	0289276	OTHER	WA	L & I
2	0289315	OTHER	WA	L & I
3	0289304	OTHER	WA	L & I

General Provider Information

NPI Number	:	1619201928
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ERICK KAMEYOSHI HARADA PT, DPT

Provider Business Mailing Address
First Line	:	31955 STATE ROUTE 20 STE A
Second Line	:
City	:	OAK HARBOR
State	:	WA
Zip	:	98277-5211
Country	:	US
Telephone Number	:	360-679-8600
Fax Number	:

Provider Business Practice Location Address
First Line	:	31955 STATE ROUTE 20
Second Line	:
City	:	OAK HARBOR
State	:	WA
Zip	:	98277-5211
Country	:	US
Telephone Number	:	360-679-8600
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/21/2009
Last Update Date	:	07/08/2021

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