Provider Demographics
NPI:1578537379
Name:ADAMS, DAVID A (PT OCS)
Entity Type:Individual
Prefix:MR
First Name:DAVID
Middle Name:A
Last Name:ADAMS
Suffix:
Gender:M
Credentials:PT OCS
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:105 W 8TH AVE
Mailing Address - Street 2:#170
Mailing Address - City:SPOKANE
Mailing Address - State:WA
Mailing Address - Zip Code:99204-2312
Mailing Address - Country:US
Mailing Address - Phone:509-838-4700
Mailing Address - Fax:509-838-4716
Practice Address - Street 1:3010 SE BLVD
Practice Address - Street 2:STE F
Practice Address - City:SPOKANE
Practice Address - State:WA
Practice Address - Zip Code:99223
Practice Address - Country:US
Practice Address - Phone:509-533-9003
Practice Address - Fax:509-533-9010
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-02-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
WAPT00002084225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA8335036Medicaid
158986OtherL & I
WAAB27489Medicare ID - Type Unspecified