Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225100000X | Physical Therapist | PT60014315 | WA |
NPI | 1003151648 |
---|---|
Provider Name | Mr. Emerson Muhat |
First Address | Lynnwood, WA 98036-6321 |
Second Address | Everett, WA 98204-3784 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/12/2012 |
Last Update Date | 08/12/2012 |