Healthcare Provider Details

I. General information

NPI: 1851530869
Provider Name (Legal Business Name): JOSHUA U MORTON LMP
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/13/2009
Last Update Date: 02/13/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

18404 102ND AVE NE
BOTHELL WA
98011-3213
US

IV. Provider business mailing address

8052 15TH AVE NE
SEATTLE WA
98115-4338
US

V. Phone/Fax

Practice location:
  • Phone: 425-770-1321
  • Fax:
Mailing address:
  • Phone: 206-992-4029
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code172M00000X
TaxonomyMechanotherapist
License NumberMA 00008567
License Number StateWA

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: