Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 225100000X | Physical Therapist | PT 468 | ID |
Y | 225100000X | Physical Therapist | PT00005703 | WA |
N | 2251H1200X | Hand | PT 468 | ID |
NPI | 1972686087 |
---|---|
Provider Name | Darrell E Krall |
First Address | Seattle, WA 98104-1132 |
Second Address | Seattle, WA 98104-1132 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 23/10/2006 |
Last Update Date | 17/02/2015 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
807271400 | (05) | ID |