Provider Demographics
NPI:1568594356
Name:DARRINGTON, BRENT (PT)
Entity Type:Individual
Prefix:
First Name:BRENT
Middle Name:
Last Name:DARRINGTON
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 1:824 W LEWIS ST STE 204
Mailing Address - Street 2:
Mailing Address - City:PASCO
Mailing Address - State:WA
Mailing Address - Zip Code:99301-5561
Mailing Address - Country:US
Mailing Address - Phone:509-544-0265
Mailing Address - Fax:509-544-0304
Practice Address - Street 1:455 E HEMLOCK ST
Practice Address - Street 2:
Practice Address - City:OTHELLO
Practice Address - State:WA
Practice Address - Zip Code:99344-1465
Practice Address - Country:US
Practice Address - Phone:509-488-0773
Practice Address - Fax:509-488-0818
Is Sole Proprietor?:No
Enumeration Date:2007-03-09
Last Update Date:2007-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPT00009468225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA0192603OtherLABOR AND INDUSTRIES
WA8415523Medicaid
WA8415523Medicaid