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General NPI Number Information
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NPI Number | 1245021104
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Entity Type | Individual
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Provider Name | GERRIT VANBEEK
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Gender | Male
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Dates
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Enumeration Date | 05/13/2025
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Last Update Date | 05/13/2025
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Provider Practice Location Address
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Address Line | 4020 136TH ST NE STE 102-103
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City | MARYSVILLE
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State | WA
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Zip | 98271-7889
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Country | US
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Telephone | 425-900-1383
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Fax |
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Provider Business Mailing Address
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Address Line | 26031 72ND AVE NW APT R284
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City | STANWOOD
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State | WA
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Zip | 98292-6330
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Country | US
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Telephone | 425-512-7883
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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 | 61681652
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License Number State | WA
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