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Individual

LUCAS A PREBLE

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
DPT

Contact information

Practice address
9419 COPPERTOP LOOP NE, BAINBRIDGE ISLAND, WA 98110-3647
(206) 842-2428
(206) 842-2890
Mailing address
9419 COPPERTOP LOOP NE, BAINBRIDGE ISLAND, WA 98110-3647
(206) 842-2428
(206) 842-2890

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT60177354
WA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0269014
L&I
WA
01
P01106205
RR MEDICARE
WA
Enumeration date
08/18/2010
Last updated
12/18/2014
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