Provider Demographics
NPI:1437143328
Name:HARADA, STEVE NARUO (PT)
Entity Type:Individual
Prefix:MR
First Name:STEVE
Middle Name:NARUO
Last Name:HARADA
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:PO BOX 798
Mailing Address - Street 2:
Mailing Address - City:COUPEVILLE
Mailing Address - State:WA
Mailing Address - Zip Code:98239-0798
Mailing Address - Country:US
Mailing Address - Phone:360-678-4191
Mailing Address - Fax:360-679-8554
Practice Address - Street 1:210 SE PIONEER WAY
Practice Address - Street 2:SUITE2
Practice Address - City:OAK HARBOR
Practice Address - State:WA
Practice Address - Zip Code:98277-5704
Practice Address - Country:US
Practice Address - Phone:360-679-8600
Practice Address - Fax:360-679-8554
Is Sole Proprietor?:Yes
Enumeration Date:2005-09-07
Last Update Date:2010-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPT00002355225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WAAB36955Medicare ID - Type Unspecified