Individual
DAVID MALDONADO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DPT
Contact information
Practice address
6601 220TH ST SW STE 1, MOUNTLAKE TERRACE, WA 98043-2166
(425) 775-7274
(425) 775-0963
Mailing address
790 REMINGTON BLVD, BOLINGBROOK, IL 60440-4909
(630) 296-2223
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
05009882A
IN
225100000X
Physical Therapist
9820
TN
225100000X
Physical Therapist
Primary
PT00008658
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000001077027
ANTHEM PROVIDER NUMBER
IN
05
—
300002166
—
IN
Enumeration date
07/14/2011
Last updated
07/21/2022
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