Provider Demographics
NPI:1043626922
Name:BIGHAM, JOSHUA (LMP)
Entity Type:Individual
Prefix:
First Name:JOSHUA
Middle Name:
Last Name:BIGHAM
Suffix:
Gender:M
Credentials:LMP
Other - Prefix:
Other - First Name:JOSH
Other - Middle Name:
Other - Last Name:BIGHAM
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LMP
Mailing Address - Street 1:3661 24TH PL W APT 207
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98199-2141
Mailing Address - Country:US
Mailing Address - Phone:206-853-4511
Mailing Address - Fax:
Practice Address - Street 1:3661 24TH PL W APT 207
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98199-2141
Practice Address - Country:US
Practice Address - Phone:206-853-4511
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-07-11
Last Update Date:2014-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA60458574225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist