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Individual
MR. MICHAEL ANDREW EGBERT
Active
Individual
MR. MICHAEL ANDREW EGBERT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PT
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT00005418
WA
225100000X
Physical Therapist
PT5418
WA
2251S0007X
Sports Physical Therapist
PT00005418
WA
2251X0800X
Orthopedic Physical Therapist
PT00005418
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
171896
L&I PROVIDER NO.
WA
01
—
246114
L&I
WA
05
—
7126303
—
WA
01
—
7421EG
BLUE SHILD BL
WA
05
—
8543712
—
WA
01
—
EG4516
BLUE SHIELD PROV. NO.
WA
01
—
P00061737
MEDICARE RAILROAD
WA
Enumeration date
10/20/2006
Last updated
10/03/2019
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