Healthcare Provider Details

I. General information

NPI: 1821919366
Provider Name (Legal Business Name): BRANDON MICHAEL STOKES PTA
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/22/2026
Last Update Date: 07/22/2026
Certification Date: 07/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2602 S 38TH ST STE C
TACOMA WA
98409-7303
US

IV. Provider business mailing address

2602 S 38TH ST STE C
TACOMA WA
98409-7303
US

V. Phone/Fax

Practice location:
  • Phone: 253-473-1585
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225200000X
TaxonomyPhysical Therapy Assistant
License NumberPTA.P1.70019963
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: