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General NPI Number Information
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NPI Number | 1154338929
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Entity Type | Individual
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Provider Name | JAMES TREVOR BRYANT PT
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Gender | Male
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Dates
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Enumeration Date | 08/02/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 200 ANDOVER PARK EAST SUITE 6
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City | TUKWILA
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State | WA
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Zip | 98188
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Country | US
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Telephone | 206-575-3182
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Fax | 206-575-0509
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Provider Business Mailing Address
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Address Line | 12131 SE 201 STREET
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City | KENT
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State | WA
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Zip | 98031
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Country | US
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Telephone | 253-852-6404
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 5441
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License Number State | WA
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