Individual
GREG A HARADA
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
DPT
Contact information
Practice address
9514 GRAVELLY LAKE DR SW, LAKEWOOD, WA 98499-1514
(253) 983-9395
(253) 983-9411
Mailing address
9315 GRAVELLY LAKE DR SW, SUITE 203, LAKEWOOD, WA 98499-1574
(253) 581-5200
(253) 581-5203
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT00008931
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
142194
LABOR & INDUSTRIES
WA
01
—
8017HA
REGENCE BLUESHIELD
WA
05
—
8339335
—
WA
01
—
8901913
L&I CRIME VICTIMS PRGM
WA
Enumeration date
06/06/2006
Last updated
07/08/2007
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