Organization
LARRY HAM AND ASSOCIATES PHYSICAL THERAPY PS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BLONDEL C ASSONKEN DPT (PRESIDENT)
(509) 532-0500
Entity
Organization
Contact information
Practice address
3010 S SOUTHEAST BLVD STE G, SPOKANE, WA 99223-3542
(509) 532-0500
(509) 532-8810
Mailing address
3010 S SOUTHEAST BLVD STE G, SPOKANE, WA 99223-3542
(509) 532-0500
(509) 532-8810
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
—
—
2251X0800X
Orthopedic Physical Therapist
PT00002269
WA
225X00000X
Occupational Therapist
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0189665
DEPT OF LABOR & INDUSTRY
WA
05
—
2009200
—
WA
01
—
603015800
US DEPT OF LABOR
—
01
—
7807634
AETNA
—
Enumeration date
09/26/2006
Last updated
04/22/2021
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