Healthcare Provider Details

I. General information

NPI: 1598190787
Provider Name (Legal Business Name): DAVID E VALENCIA DPT, ATC, CSCS
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/06/2013
Last Update Date: 05/24/2021
Certification Date: 05/24/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1215 4TH AVE STE 1000
SEATTLE WA
98161-1017
US

IV. Provider business mailing address

1215 4TH AVE STE 1000
SEATTLE WA
98161-1017
US

V. Phone/Fax

Practice location:
  • Phone: 206-622-9001
  • Fax: 206-622-4311
Mailing address:
  • Phone: 206-622-9001
  • Fax: 206-622-4311

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2255A2300X
TaxonomyAthletic Trainer
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code2251S0007X
TaxonomySports Physical Therapist
License Number040612
License Number StateNY
# 3
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number60917750
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: