Provider Demographics
NPI:1033100441
Name:BUTHEAU, PIERRE-YVES FREDERIC (MSPT)
Entity Type:Individual
Prefix:MR
First Name:PIERRE-YVES
Middle Name:FREDERIC
Last Name:BUTHEAU
Suffix:
Gender:M
Credentials:MSPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15034 5TH LN S
Mailing Address - Street 2:
Mailing Address - City:BURIEN
Mailing Address - State:WA
Mailing Address - Zip Code:98148-2551
Mailing Address - Country:US
Mailing Address - Phone:425-281-4171
Mailing Address - Fax:
Practice Address - Street 1:15034 5TH LN S
Practice Address - Street 2:
Practice Address - City:BURIEN
Practice Address - State:WA
Practice Address - Zip Code:98148-2551
Practice Address - Country:US
Practice Address - Phone:425-281-4171
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2005-11-03
Last Update Date:2017-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPT00009004225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WAG8871431Medicare PIN