Provider Demographics
NPI:1407369523
Name:SINGH, PERMINDER (PTA)
Entity Type:Individual
Prefix:MR
First Name:PERMINDER
Middle Name:
Last Name:SINGH
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 1:543 OVERLAKE DR E
Mailing Address - Street 2:
Mailing Address - City:MEDINA
Mailing Address - State:WA
Mailing Address - Zip Code:98039-5326
Mailing Address - Country:US
Mailing Address - Phone:253-229-2188
Mailing Address - Fax:
Practice Address - Street 1:543 OVERLAKE DR E
Practice Address - Street 2:
Practice Address - City:MEDINA
Practice Address - State:WA
Practice Address - Zip Code:98039-5326
Practice Address - Country:US
Practice Address - Phone:253-229-2188
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-11-10
Last Update Date:2017-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAP160792833225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant