Healthcare Provider Details

I. General information

NPI: 1508980004
Provider Name (Legal Business Name): MATTHEW PATTON GAINES PT, DPT
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/19/2007
Last Update Date: 04/06/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

UWMC PHYSICAL THERAPY DEPARTMENT 1959 NE PACIFIC ST.
SEATTLE WA
98195-0001
US

IV. Provider business mailing address

UWMC PHYSICAL THERAPY DEPARTMENT 1959 NE PACIFIC ST.
SEATTLE WA
98195-0001
US

V. Phone/Fax

Practice location:
  • Phone: 206-598-4830
  • Fax: 206-598-4897
Mailing address:
  • Phone: 206-598-4830
  • Fax: 206-598-4897

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number020561
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: