Individual
JOHANNES G VANBUUREN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PT
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT00005285
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0039585
LABOR AND INDUSTRIES #
WA
05
—
8348598
—
WA
01
—
P00213131
RAILROAD MC#
WA
01
—
US1052073
AETNA SPECIALIST PIN
WA
01
—
VA3549
BLUE SHIELD #
WA
Enumeration date
02/20/2007
Last updated
04/16/2008
Update your record
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