Provider Demographics
NPI:1639310576
Name:SATO, MATTHEW MITSUO (DPT)
Entity Type:Individual
Prefix:DR
First Name:MATTHEW
Middle Name:MITSUO
Last Name:SATO
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8495 161ST AVE NE
Mailing Address - Street 2:
Mailing Address - City:REDMOND
Mailing Address - State:WA
Mailing Address - Zip Code:98052-3805
Mailing Address - Country:US
Mailing Address - Phone:425-881-3001
Mailing Address - Fax:425-881-3585
Practice Address - Street 1:8495 161ST AVE NE
Practice Address - Street 2:
Practice Address - City:REDMOND
Practice Address - State:WA
Practice Address - Zip Code:98052-3805
Practice Address - Country:US
Practice Address - Phone:425-881-3001
Practice Address - Fax:425-881-3585
Is Sole Proprietor?:Yes
Enumeration Date:2009-03-23
Last Update Date:2009-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPT60080166225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist