Provider Demographics
NPI:1043751191
Name:TOWNSEND, MATTHEW (ATC)
Entity Type:Individual
Prefix:MR
First Name:MATTHEW
Middle Name:
Last Name:TOWNSEND
Suffix:
Gender:M
Credentials:ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9420 49TH AVE W
Mailing Address - Street 2:20A
Mailing Address - City:MUKILTEO
Mailing Address - State:WA
Mailing Address - Zip Code:98275-3750
Mailing Address - Country:US
Mailing Address - Phone:425-330-8573
Mailing Address - Fax:
Practice Address - Street 1:9420 49TH AVE W
Practice Address - Street 2:20A
Practice Address - City:MUKILTEO
Practice Address - State:WA
Practice Address - Zip Code:98275-3750
Practice Address - Country:US
Practice Address - Phone:425-330-8573
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-03-08
Last Update Date:2017-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IDAT-5492255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer