Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225100000X | Physical Therapist | PT00009286 | WA |
NPI | 1003069725 |
---|---|
Provider Name | Ryan Patrick Haskell |
First Address | Everett, WA 98206-5127 |
Second Address | Marysville, WA 98271-4743 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 25/10/2008 |
Last Update Date | 03/04/2017 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0242005 | L&I (01) | WA |
0248638 | L&I (01) | WA |
5305HA | REGENCE (01) | WA |
5307HA | REGENCE (01) | WA |
5308HA | REGENCE (01) | WA |
5309HA | REGENCE (01) | WA |
5311HA | REGENCE (01) | WA |
8402620 | DSHS (01) | WA |
8949261 | L&I CRIME VICTIMS (01) | WA |
8951177 | L&I CRIME VICTIMS (01) | WA |