Provider Demographics
NPI:1639178361
Name:CHURCHES, DANIEL ARTHUR (PT)
Entity Type:Individual
Prefix:MR
First Name:DANIEL
Middle Name:ARTHUR
Last Name:CHURCHES
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:PO BOX 368
Mailing Address - Street 2:
Mailing Address - City:OLYMPIA
Mailing Address - State:WA
Mailing Address - Zip Code:98507-0368
Mailing Address - Country:US
Mailing Address - Phone:360-709-6221
Mailing Address - Fax:360-359-4727
Practice Address - Street 1:3901 CAPITAL MALL DR SW
Practice Address - Street 2:STE D
Practice Address - City:OLYMPIA
Practice Address - State:WA
Practice Address - Zip Code:98502-8654
Practice Address - Country:US
Practice Address - Phone:360-709-6221
Practice Address - Fax:360-359-4727
Is Sole Proprietor?:No
Enumeration Date:2005-07-15
Last Update Date:2014-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPT00005833225100000X
WAPT00005833 WA2251X0800X, 2251S0007X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
No2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic
No2251S0007XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistSports
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA1467632745OtherGROUP NPI
WA8853662Medicare ID - Type UnspecifiedMEDICARE PROVIDER NUMBER
WA0196560OtherLABOR & INDUSTRIES
WA8425043Medicaid