Individual
ETHAN JAY LIVINGSTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
16310 BOTHELL EVERETT HWY STE C, MILL CREEK, WA 98012-1284
(425) 582-5526
Mailing address
790 REMINGTON BLVD, BOLINGBROOK, IL 60440-4909
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
—
—
Other
Enumeration date
04/28/2021
Last updated
04/28/2021
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