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NPI Code Detail

MEDICARE: MANDY M PRITCHARD MPT

MEDICARE:   MANDY M PRITCHARD  MPT
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1225100000XPhysical TherapistPT00009096WA

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
5P00014671OTHERWARAILROAD MEDICARE

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
15224MOOTHERWAREGENCE BLUE SHIELD
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3169771OTHERWADEPT OF LABOR & INDUSTRIE
48934739OTHERWACRIME VICTIMS

General Provider Information

NPI Number : 1598729642
Entity Type Code : Individual
Provider Name (Legal Business Name) : MANDY M PRITCHARD MPT
Provider Business Mailing Address
First Line : PO BOX 731269
Second Line :
City : PUYALLUP
State : WA
Zip : 98373-0060
Country : US
Telephone Number : 253-840-2313
Fax Number : 253-840-6340
Provider Business Practice Location Address
First Line : 17650 140TH AVE SE
Second Line : #B-07
City : RENTON
State : WA
Zip : 98058-6814
Country : US
Telephone Number : 425-430-0700
Fax Number : 425-430-0710
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/14/2006
Last Update Date : 07/09/2007

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Directions to “ MANDY M PRITCHARD MPT” Practice Location

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