Provider Demographics
NPI:1134475957
Name:MANN, PAUL J (DPT)
Entity Type:Individual
Prefix:
First Name:PAUL
Middle Name:J
Last Name:MANN
Suffix:
Gender:M
Credentials:DPT
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Mailing Address - Street 1:1 LAKE BELLEVUE DR
Mailing Address - Street 2:SUITE 100
Mailing Address - City:BELLEVUE
Mailing Address - State:WA
Mailing Address - Zip Code:98005-2417
Mailing Address - Country:US
Mailing Address - Phone:425-462-4330
Mailing Address - Fax:425-462-4335
Practice Address - Street 1:1260 116TH AVE NE
Practice Address - Street 2:SUITE 200
Practice Address - City:BELLEVUE
Practice Address - State:WA
Practice Address - Zip Code:98004-3800
Practice Address - Country:US
Practice Address - Phone:425-450-9801
Practice Address - Fax:425-450-9778
Is Sole Proprietor?:Yes
Enumeration Date:2012-07-30
Last Update Date:2012-07-30
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
WA60298619225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist