Provider Demographics
NPI:1598862757
Name:SAELENS, DAVID MARSHAL (MPT)
Entity Type:Individual
Prefix:MR
First Name:DAVID
Middle Name:MARSHAL
Last Name:SAELENS
Suffix:
Gender:M
Credentials:MPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4760 E FENNEC FOX LN
Mailing Address - Street 2:
Mailing Address - City:POST FALLS
Mailing Address - State:ID
Mailing Address - Zip Code:83854-0023
Mailing Address - Country:US
Mailing Address - Phone:206-552-1222
Mailing Address - Fax:
Practice Address - Street 1:3322 N GRAND MILL LN
Practice Address - Street 2:
Practice Address - City:COEUR D ALENE
Practice Address - State:ID
Practice Address - Zip Code:83814-5689
Practice Address - Country:US
Practice Address - Phone:206-552-1222
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-20
Last Update Date:2019-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA603262552251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA2042176Medicaid
CO11752840Medicaid
WAG8937732Medicare PIN
CO11752840Medicaid