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Individual
MATTHEW GERVAIS
Active
Individual
MATTHEW GERVAIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PT
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
295668
CA
225100000X
Physical Therapist
60757662
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1912436676
—
WA
01
—
G8967799
MEDICARE
WA
Enumeration date
06/07/2017
Last updated
01/25/2022
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