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Individual
LUCAS A PREBLE
Active
Individual
LUCAS A PREBLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DPT
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT60177354
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0269014
L&I
WA
01
—
P01106205
RR MEDICARE
WA
Enumeration date
08/18/2010
Last updated
12/18/2014
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