Provider Demographics
NPI:1376741488
Name:MACHTMES, ALAN (PTA/LMP)
Entity Type:Individual
Prefix:
First Name:ALAN
Middle Name:
Last Name:MACHTMES
Suffix:
Gender:M
Credentials:PTA/LMP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11915 E BROADWAY AVE
Mailing Address - Street 2:STE 101
Mailing Address - City:SPOKANE VALLEY
Mailing Address - State:WA
Mailing Address - Zip Code:99206-4997
Mailing Address - Country:US
Mailing Address - Phone:509-228-9404
Mailing Address - Fax:
Practice Address - Street 1:11915 E BROADWAY AVE
Practice Address - Street 2:STE 101
Practice Address - City:SPOKANE VALLEY
Practice Address - State:WA
Practice Address - Zip Code:99206-4997
Practice Address - Country:US
Practice Address - Phone:509-228-9404
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-07-10
Last Update Date:2012-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA00004285225700000X
WAP160043884225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant
No225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist