Provider Demographics
NPI:1487651279
Name:HOPE, GARY WILLIAM (PT)
Entity Type:Individual
Prefix:
First Name:GARY
Middle Name:WILLIAM
Last Name:HOPE
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 1:22840 NE 8TH STREET
Mailing Address - Street 2:SUITE 102
Mailing Address - City:SAMMAMISH
Mailing Address - State:WA
Mailing Address - Zip Code:98074-7263
Mailing Address - Country:US
Mailing Address - Phone:425-898-8540
Mailing Address - Fax:425-898-1570
Practice Address - Street 1:22840 NE 8TH STREET
Practice Address - Street 2:SUITE 102
Practice Address - City:SAMMAMISH
Practice Address - State:WA
Practice Address - Zip Code:98074-7263
Practice Address - Country:US
Practice Address - Phone:425-898-8540
Practice Address - Fax:425-898-1570
Is Sole Proprietor?:Yes
Enumeration Date:2005-07-07
Last Update Date:2010-04-01
Deactivation Date:2006-03-21
Deactivation Code:
Reactivation Date:2006-04-03
Provider Licenses
StateLicense IDTaxonomies
WA1084225100000X
WAPT00001084225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA8809331Medicare UPIN