Provider Demographics
NPI:1023356920
Name:ENGRACIA, RAMON F JR
Entity Type:Individual
Prefix:
First Name:RAMON
Middle Name:F
Last Name:ENGRACIA
Suffix:JR
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15809 BEAR CREEK PKWY STE 100
Mailing Address - Street 2:
Mailing Address - City:REDMOND
Mailing Address - State:WA
Mailing Address - Zip Code:98052-1542
Mailing Address - Country:US
Mailing Address - Phone:425-882-6100
Mailing Address - Fax:425-882-7690
Practice Address - Street 1:15809 BEAR CREEK PKWY STE 100
Practice Address - Street 2:
Practice Address - City:REDMOND
Practice Address - State:WA
Practice Address - Zip Code:98052-1542
Practice Address - Country:US
Practice Address - Phone:425-882-6100
Practice Address - Fax:425-882-7690
Is Sole Proprietor?:No
Enumeration Date:2013-01-28
Last Update Date:2021-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPT60572578225100000X
AZ8765PT225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist