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Individual

DAVID ANTHONY THERRATTIL

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
23505 E APPLEWAY AVE, STE. 106, LIBERTY LAKE, WA 99019-6003
(509) 891-2258
(509) 891-2094
Mailing address
16083 SW UPPER BOONES FERRY RD, SUITE 300, TIGARD, OR 97224-7736
(800) 219-8835
(503) 639-9699

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
60330269
WA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
12058/12062
WA
01
P01196889
RR MEDICARE
WA
Enumeration date
03/11/2013
Last updated
09/09/2013
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