Provider Demographics
NPI:1093891541
Name:MCVEIN, JOSEPH D (BSPT)
Entity Type:Individual
Prefix:
First Name:JOSEPH
Middle Name:D
Last Name:MCVEIN
Suffix:
Gender:M
Credentials:BSPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 2170
Mailing Address - Street 2:
Mailing Address - City:SUMNER
Mailing Address - State:WA
Mailing Address - Zip Code:98390-0480
Mailing Address - Country:US
Mailing Address - Phone:253-840-2313
Mailing Address - Fax:253-840-6340
Practice Address - Street 1:6985 COAL CREEK PKWY SE
Practice Address - Street 2:
Practice Address - City:NEWCASTLE
Practice Address - State:WA
Practice Address - Zip Code:98059-3136
Practice Address - Country:US
Practice Address - Phone:425-378-0500
Practice Address - Fax:425-378-8168
Is Sole Proprietor?:No
Enumeration Date:2006-10-27
Last Update Date:2008-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPT00005111225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA650018965OtherRAILROAD MEDICARE
WA8935152OtherCRIME VICTIMS
WA7861MCOtherREGENCE BLUE SHIELD
WAA006OtherTRICARE
WA8324444Medicaid
WA139665OtherDEPT OF LABOR & INDUSTRY
WA7861MCOtherREGENCE BLUE SHIELD