Individual
JOSEPH G BANACH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PT
Contact information
Practice address
22500 NE MARKETPLACE DR, SUITE 204, REDMOND, WA 98053-2033
(425) 836-1034
(425) 836-1037
Mailing address
1519 132ND ST SE, SUITE A, EVERETT, WA 98208-7203
(425) 330-0633
(425) 338-9637
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0192795
DEPT. OF LABOR & INDUSTRY
WA
01
—
0232276
LABOR & INDUSTRIES
WA
01
—
0275625
L&I
WA
01
—
0693BA
REGENCE
WA
01
—
2250BA
REGENCE
WA
01
—
5303BA
REGENCE BLUE SHIELD
WA
01
—
7312449
AETNA
WA
01
—
8340622
DSHS
WA
01
—
8939859
L & I CRIME VICTIMS
WA
01
—
911745305-98053-A005
TRICARE
WA
01
—
9847BA
REGENCE BLUE SHIELD
WA
01
—
G8872200
MEDICARE
WA
01
—
P00353317
RAILROAD MEDICARE
WA
01
—
P00473355
RAILROAD MEDICARE
WA
Enumeration date
04/04/2006
Last updated
01/25/2012
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