Individual
ERIC C O'FALLON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DPT
Contact information
Practice address
1519 132ND ST SE, SUITE A, EVERETT, WA 98208-7203
(425) 337-9556
Mailing address
1519 132ND ST SE, SUITE A, EVERETT, WA 98208-7203
(425) 357-9380
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT60205220
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0275550
L&I
WA
01
—
0275587
L&I
WA
01
—
0275589
L&I
WA
01
—
0275594
L&I
WA
01
—
1922305424
DSHS
WA
Enumeration date
02/17/2011
Last updated
01/25/2012
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