Provider Demographics
NPI:1346554375
Name:SUMIDA, BRYCE K (DPT)
Entity Type:Individual
Prefix:DR
First Name:BRYCE
Middle Name:K
Last Name:SUMIDA
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:4411 POINT FOSDICK DR NW
Mailing Address - Street 2:SUITE 101
Mailing Address - City:GIG HARBOR
Mailing Address - State:WA
Mailing Address - Zip Code:98335-1703
Mailing Address - Country:US
Mailing Address - Phone:253-851-7472
Mailing Address - Fax:253-851-7473
Practice Address - Street 1:4411 POINT FOSDICK DR NW
Practice Address - Street 2:SUITE 101
Practice Address - City:GIG HARBOR
Practice Address - State:WA
Practice Address - Zip Code:98335-1703
Practice Address - Country:US
Practice Address - Phone:253-851-7472
Practice Address - Fax:253-851-7473
Is Sole Proprietor?:No
Enumeration Date:2010-08-02
Last Update Date:2010-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPT60160960225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist