Provider Demographics
NPI:1164602744
Name:WARD, PATRICK JOHN (PTA)
Entity Type:Individual
Prefix:MR
First Name:PATRICK
Middle Name:JOHN
Last Name:WARD
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 1:920 ANDERSON DR
Mailing Address - Street 2:ATTN: THERAPY DEPARTMENT
Mailing Address - City:ABERDEEN
Mailing Address - State:WA
Mailing Address - Zip Code:98520-1007
Mailing Address - Country:US
Mailing Address - Phone:360-532-5122
Mailing Address - Fax:
Practice Address - Street 1:920 ANDERSON DR
Practice Address - Street 2:ATTN: THERAPY DEPARTMENT
Practice Address - City:ABERDEEN
Practice Address - State:WA
Practice Address - Zip Code:98520-1007
Practice Address - Country:US
Practice Address - Phone:360-532-5122
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-11-12
Last Update Date:2007-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant