Individual
ALEXANDER WIRTA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PT
Contact information
Practice address
19017 120TH AVE NE BLDG 1, SUITE 111, BOTHELL, WA 98011-9510
(425) 489-3420
(425) 489-3421
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
PT 60555817
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1134597404
—
WA
Enumeration date
09/03/2015
Last updated
05/03/2017
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