Basic Information
Provider Information | |||||||||
NPI: | 1598957664 | ||||||||
EntityType: | 1 | ||||||||
ReplacementNPI: |   | ||||||||
OrganizationName: |   | ||||||||
LastName: | STRANDY | ||||||||
FirstName: | JAMES | ||||||||
MiddleName: | ZACHARY | ||||||||
NamePrefix: |   | ||||||||
NameSuffix: |   | ||||||||
Credential: | DPT | ||||||||
OtherOrganizationName: |   | ||||||||
OtherOrganizationType: |   | ||||||||
OtherLastName: | STRANDY | ||||||||
OtherFirstName: | J | ||||||||
OtherMiddleName: | ZACHARY | ||||||||
OtherNamePrefix: |   | ||||||||
OtherNameSuffix: |   | ||||||||
OtherCredential: | DPT | ||||||||
OtherLastNameType: | 5 | ||||||||
Mailing Information | |||||||||
Address1: | 407 E 2ND AVE STE 100 | ||||||||
Address2: |   | ||||||||
City: | SPOKANE | ||||||||
State: | WA | ||||||||
PostalCode: | 992021428 | ||||||||
CountryCode: | US | ||||||||
TelephoneNumber: | 5094556002 | ||||||||
FaxNumber: | 5097475990 | ||||||||
Practice Location | |||||||||
Address1: | 407 E 2ND AVE STE 100 | ||||||||
Address2: |   | ||||||||
City: | SPOKANE | ||||||||
State: | WA | ||||||||
PostalCode: | 992021428 | ||||||||
CountryCode: | US | ||||||||
TelephoneNumber: | 5094556002 | ||||||||
FaxNumber: | 5097475990 | ||||||||
Other Information | |||||||||
ProviderEnumerationDate: | 08/13/2007 | ||||||||
LastUpdateDate: | 05/25/2016 | ||||||||
NPIDeactivationReasonCode: |   | ||||||||
NPIDeactivationDate: |   | ||||||||
NPIReactivationDate: |   | ||||||||
ProviderGenderCode: | M | ||||||||
AuthorizedOfficialLastName: |   | ||||||||
AuthorizedOfficialFirstName: |   | ||||||||
AuthorizedOfficialMiddleName: |   | ||||||||
AuthorizedOfficialTitleorPosition: |   | ||||||||
AuthorizedOfficialTelephone: |   | ||||||||
IsSoleProprietor: | N | ||||||||
IsOrganizationSubpart: |   | ||||||||
ParentOrganizationLBN: |   | ||||||||
AuthorizedOfficialNamePrefix: |   | ||||||||
AuthorizedOfficialNameSuffix: |   | ||||||||
AuthorizedOfficialCredential: |   | ||||||||
NPICertificationDate: |   |
Taxonomy Information
Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 225100000X | PT00010691 | WA | Y |   | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist |   |
ID Information
ID | Type | State | Issuer | Description | 0223897 | 01 | WA | WA DEPT OF LABOR & INDUSTRIES | OTHER | 8495897 | 05 | WA |   | MEDICAID |