Basic Information
| Provider Information | |||||||||
| NPI: | 1447999636 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | STOPKA | ||||||||
| FirstName: | DANIEL | ||||||||
| MiddleName: | TIMOTHY | ||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | DPT | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1608 S 24TH AVE STE 102 | ||||||||
| Address2: | |||||||||
| City: | YAKIMA | ||||||||
| State: | WA | ||||||||
| PostalCode: | 989025771 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5092486113 | ||||||||
| FaxNumber: | 5094578941 | ||||||||
| Practice Location | |||||||||
| Address1: | 1608 S 24TH AVE | ||||||||
| Address2: | |||||||||
| City: | YAKIMA | ||||||||
| State: | WA | ||||||||
| PostalCode: | 989025771 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5092486113 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 06/03/2022 | ||||||||
| LastUpdateDate: | 06/03/2022 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 06/03/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 225100000X | PT61285740 | WA | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist |
No ID Information.