Healthcare Provider Details

I. General information

NPI: 1659455418
Provider Name (Legal Business Name): LUKE PAUL ASTELL P.T.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/25/2006
Last Update Date: 04/12/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10171A CHUMSTICK HWY
LEAVENWORTH WA
98826-9267
US

IV. Provider business mailing address

10171A CHUMSTICK HWY
LEAVENWORTH WA
98826-9267
US

V. Phone/Fax

Practice location:
  • Phone: 509-548-3133
  • Fax: 509-548-5356
Mailing address:
  • Phone: 509-548-3133
  • Fax: 509-548-5356

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberPT00005526
License Number StateWV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: