Provider Demographics
NPI:1437112018
Name:BROOKES, ALLISTER R (PT)
Entity Type:Individual
Prefix:
First Name:ALLISTER
Middle Name:R
Last Name:BROOKES
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1519 132ND ST SE
Mailing Address - Street 2:SUITE A
Mailing Address - City:EVERETT
Mailing Address - State:WA
Mailing Address - Zip Code:98208-7203
Mailing Address - Country:US
Mailing Address - Phone:425-330-0633
Mailing Address - Fax:425-338-9637
Practice Address - Street 1:1830 BICKFORD AVE
Practice Address - Street 2:SUITE 209
Practice Address - City:SNOHOMISH
Practice Address - State:WA
Practice Address - Zip Code:98290-1749
Practice Address - Country:US
Practice Address - Phone:360-568-7774
Practice Address - Fax:360-568-7779
Is Sole Proprietor?:No
Enumeration Date:2006-04-06
Last Update Date:2012-01-25
Deactivation Date:
Deactivation Code:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA8932323OtherL & I CRIME VICTIMS
WA3854BROtherREGENCE BLUE SHIELD
WA0171929OtherDEPT. OF LABOR & INDUSTRY
WA331058838-98290-A002OtherTRICARE
WA8332546Medicaid
WAP00063963OtherRAILROAD MEDICARE
WA7012218OtherAETNA
WA3854BROtherREGENCE BLUE SHIELD
WA6084090001Medicare NSC