Basic Information
| Provider Information | |||||||||
| NPI: | 1154072486 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | MARMET | ||||||||
| FirstName: | ANTHONY | ||||||||
| MiddleName: | MICHAEL | ||||||||
| NamePrefix: | DR. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 162 COUNTY HIGHWAY 12 | ||||||||
| Address2: | |||||||||
| City: | LAURENS | ||||||||
| State: | NY | ||||||||
| PostalCode: | 137961115 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6072671768 | ||||||||
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| Practice Location | |||||||||
| Address1: | 13242 AURORA AVE N STE 103 | ||||||||
| Address2: | |||||||||
| City: | SEATTLE | ||||||||
| State: | WA | ||||||||
| PostalCode: | 981337026 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2064200221 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 01/18/2022 | ||||||||
| LastUpdateDate: | 01/18/2022 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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| NPICertificationDate: | 01/18/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 225100000X | 61204486 | WA | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist |
No ID Information.