Provider Demographics
NPI:1417997164
Name:MARRS, DONALD T (PT)
Entity Type:Individual
Prefix:
First Name:DONALD
Middle Name:T
Last Name:MARRS
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15965 NE 85TH ST FL 2
Mailing Address - Street 2:
Mailing Address - City:REDMOND
Mailing Address - State:WA
Mailing Address - Zip Code:98052-3531
Mailing Address - Country:US
Mailing Address - Phone:425-867-0740
Mailing Address - Fax:425-867-0750
Practice Address - Street 1:15965 NE 85TH ST FL 2
Practice Address - Street 2:
Practice Address - City:REDMOND
Practice Address - State:WA
Practice Address - Zip Code:98052-3531
Practice Address - Country:US
Practice Address - Phone:425-867-0740
Practice Address - Fax:425-867-0750
Is Sole Proprietor?:No
Enumeration Date:2006-06-08
Last Update Date:2008-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPT00001025225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WAGAB19705Medicare PIN