Provider Demographics
NPI:1417025131
Name:ISAAK, JAMES H (PHYSICAL THERAPIST)
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:H
Last Name:ISAAK
Suffix:
Gender:M
Credentials:PHYSICAL THERAPIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1503 NE 78TH ST
Mailing Address - Street 2:STE 9
Mailing Address - City:VANCOUVER
Mailing Address - State:WA
Mailing Address - Zip Code:98665-9666
Mailing Address - Country:US
Mailing Address - Phone:360-573-5500
Mailing Address - Fax:360-573-9075
Practice Address - Street 1:1503 NE 78TH ST
Practice Address - Street 2:STE 9
Practice Address - City:VANCOUVER
Practice Address - State:WA
Practice Address - Zip Code:98665-9666
Practice Address - Country:US
Practice Address - Phone:360-573-5500
Practice Address - Fax:360-573-9075
Is Sole Proprietor?:No
Enumeration Date:2006-12-01
Last Update Date:2013-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPT00000930225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA8868022OtherMEDICARE PTAN
WA8868022OtherMEDICARE PTAN