Healthcare Provider Details

I. General information

NPI: 1659095743
Provider Name (Legal Business Name): JOSEPH HOUSTON
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/03/2022
Last Update Date: 08/04/2026
Certification Date: 08/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

817 E PLUM ST
MOSES LAKE WA
98837-1870
US

IV. Provider business mailing address

760 N CENTRAL DR APT 317
MOSES LAKE WA
98837-3248
US

V. Phone/Fax

Practice location:
  • Phone: 509-765-7835
  • Fax:
Mailing address:
  • Phone: 314-852-5773
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225200000X
TaxonomyPhysical Therapy Assistant
License NumberPTA.P1.70141533
License Number StateWA
# 2
Primary TaxonomyY
Taxonomy Code225200000X
TaxonomyPhysical Therapy Assistant
License Number2021015163
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: