Healthcare Provider Details

I. General information

NPI: 1669714036
Provider Name (Legal Business Name): MURRAY ERNEST MAITLAND PHD PT
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/22/2013
Last Update Date: 03/22/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

UNIVERSITY OF WASHINGTON 1959 PACIFIC ST NE
SEATTLE WA
98195-6490
US

IV. Provider business mailing address

UNIVERSITY OF WASHINGTON 1959 PACIFIC ST NE
SEATTLE WA
98195-6490
US

V. Phone/Fax

Practice location:
  • Phone: 206-598-5342
  • Fax: 206-685-3244
Mailing address:
  • Phone: 206-598-5342
  • Fax: 206-685-3244

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberPT00010569
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: