Basic Information
Provider Information
NPI: 1689765323
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: CATES
FirstName: SHAWN
MiddleName: DUGGAN
NamePrefix:  
NameSuffix:  
Credential: P.T.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 7315 212TH ST SW
Address2: SUITE 104
City: EDMONDS
State: WA
PostalCode: 980267610
CountryCode: US
TelephoneNumber: 4257743226
FaxNumber: 4256701406
Practice Location
Address1: 7315 212TH ST SW
Address2: SUITE 104
City: EDMONDS
State: WA
PostalCode: 980267610
CountryCode: US
TelephoneNumber: 4257743226
FaxNumber: 4256701406
Other Information
ProviderEnumerationDate: 09/27/2006
LastUpdateDate: 07/08/2007
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
225100000XPT00002026WAY Respiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist 

No ID Information.


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