1598957664 NPI number — JAMES ZACHARY STRANDY DPT

Table of content: JAMES ZACHARY STRANDY DPT (NPI 1598957664)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1598957664 NPI number — JAMES ZACHARY STRANDY DPT

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
STRANDY
Provider First Name:
JAMES
Provider Middle Name:
ZACHARY
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
DPT
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
STRANDY
Provider Other First Name:
J
Provider Other Middle Name:
ZACHARY
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
DPT
Provider Other Last Name Type Code:
5

NPI Number Information

NPI Number:
1598957664
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
05/25/2016
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
407 E 2ND AVE STE 100
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
SPOKANE
Provider Business Mailing Address State Name:
WA
Provider Business Mailing Address Postal Code:
99202-1428
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
509-455-6002
Provider Business Mailing Address Fax Number:
509-747-5990

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
407 E 2ND AVE STE 100
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
SPOKANE
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
99202-1428
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
509-455-6002
Provider Business Practice Location Address Fax Number:
509-747-5990
Provider Enumeration Date:
08/13/2007

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 225100000X , with the licence number:  PT00010691 , registered in the state of WA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 0223897 . This is a "WA DEPT OF LABOR & INDUSTRIES" identifier , issued by the state of ( WA ) . This identifiers is of the category "OTHER".
  • Identifier: 8495897 , issued by the state of ( WA ) . This identifiers is of the category "MEDICAID".