Provider Demographics
NPI:1508309634
Name:GACAD, FELIX (PT)
Entity Type:Individual
Prefix:
First Name:FELIX
Middle Name:
Last Name:GACAD
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 1:669 MULLIS ST
Mailing Address - Street 2:SUITE 102
Mailing Address - City:FRIDAY HARBOR
Mailing Address - State:WA
Mailing Address - Zip Code:98250-7902
Mailing Address - Country:US
Mailing Address - Phone:360-370-5226
Mailing Address - Fax:360-370-5559
Practice Address - Street 1:669 MULLIS ST
Practice Address - Street 2:SUITE 102
Practice Address - City:FRIDAY HARBOR
Practice Address - State:WA
Practice Address - Zip Code:98250-7902
Practice Address - Country:US
Practice Address - Phone:360-370-5226
Practice Address - Fax:360-370-5559
Is Sole Proprietor?:Yes
Enumeration Date:2016-11-21
Last Update Date:2016-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA000037802251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic