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Individual

MR. JAMES C FULLER

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
PHYSICAL THERAPIST

Contact information

Practice address
31200 23RD AVE SOUTH, FEDERAL WAY, WA 98003
(253) 839-3403
(253) 839-3412
Mailing address
PO BOX 6225, FEDERAL WAY, WA 98063
(253) 839-3403
(253) 839-3412

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
PT3076
WA
225100000X
Physical Therapist
Primary
2251G0304X
Geriatric Physical Therapist
PT3076
WA
2251G0304X
Geriatric Physical Therapist

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
7096167
WA
01
G8870695
MEDICARE PTAN
WA
Enumeration date
07/26/2005
Last updated
06/09/2014
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