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General NPI Number Information
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NPI Number | 1881029601
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Entity Type | Individual
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Provider Name | JOSHUA CHASE ANDERSON PTA/L
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Gender | Male
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Dates
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Enumeration Date | 09/11/2013
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Last Update Date | 09/11/2013
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Provider Practice Location Address
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Address Line | 15623 1ST AVE S STE C
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City | BURIEN
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State | WA
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Zip | 98148-1292
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Country | US
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Telephone | 206-444-6320
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Fax | 206-444-3602
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Provider Business Mailing Address
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Address Line | 8714 E MEADOW LAKE DR
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City | SNOHOMISH
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State | WA
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Zip | 98290-7201
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Country | US
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Telephone | 425-232-9065
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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 | 225200000X
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Taxonomy Name | Physical Therapy Assistant
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License Number | P1 60064421
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License Number State | WA
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