Thacker, Brian A
Thacker, Brian A is an individual health care provider with primary practice located at 17520 Meridian E Ste F, Puyallup WA 98375-6265. He recently has only one registered license in Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapist, which is considered as his primary health care specialty. Thacker, Brian A can be contacted via phone (253) 864-7595.Contact Information
Primary practice address
17520 Meridian E Ste F
Puyallup WA 98375-6265
Phone: (253) 864-7595
Fax: (253) 864-0457
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapist | 225100000X | PT00007968 | Washington |
Profile Details
| NPI number | 1376536243 |
|---|---|
| LBN Legal business name | Thacker, Brian A |
| Credentials | DPT, OCS, SCS, COMT |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Aug 25th, 2005 |
| Last updated | May 21st, 2013 - about 12 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1376536243 | NPPES |
| Washington | Other | 306726 | L&I PROVIDER ID |
| Washington | MEDICAID | 7092208 | L&I PROVIDER ID |
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