Provider Demographics
NPI:1104394048
Name:SALINAS, DAVID ANGELO (PTA)
Entity Type:Individual
Prefix:
First Name:DAVID
Middle Name:ANGELO
Last Name:SALINAS
Suffix:
Gender:M
Credentials:PTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6306 N ASSEMBLY ST
Mailing Address - Street 2:
Mailing Address - City:SPOKANE
Mailing Address - State:WA
Mailing Address - Zip Code:99208-5071
Mailing Address - Country:US
Mailing Address - Phone:509-840-0497
Mailing Address - Fax:
Practice Address - Street 1:1225 N ARGONNE RD STE 100
Practice Address - Street 2:
Practice Address - City:SPOKANE VALLEY
Practice Address - State:WA
Practice Address - Zip Code:99212-2798
Practice Address - Country:US
Practice Address - Phone:509-505-5315
Practice Address - Fax:509-530-2837
Is Sole Proprietor?:No
Enumeration Date:2018-11-08
Last Update Date:2023-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA160865166225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA160865166Medicaid