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Individual
PHILIP VANDE POL
Active
Individual
PHILIP VANDE POL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PT, DPT
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
4927
OR
225100000X
Physical Therapist
Primary
PT00010802
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1639155237
—
WA
05
—
278011
—
OR
05
—
8501348
—
WA
Enumeration date
12/16/2005
Last updated
11/03/2010
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