Provider Demographics
NPI:1699808113
Name:DRUMHELLER, PAUL (MPT, OCS, CSCS)
Entity Type:Individual
Prefix:
First Name:PAUL
Middle Name:
Last Name:DRUMHELLER
Suffix:
Gender:M
Credentials:MPT, OCS, CSCS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5317 S 282ND WAY
Mailing Address - Street 2:
Mailing Address - City:AUBURN
Mailing Address - State:WA
Mailing Address - Zip Code:98001-1926
Mailing Address - Country:US
Mailing Address - Phone:253-468-4700
Mailing Address - Fax:
Practice Address - Street 1:1 N TACOMA AVE
Practice Address - Street 2:STE 103
Practice Address - City:TACOMA
Practice Address - State:WA
Practice Address - Zip Code:98403-3131
Practice Address - Country:US
Practice Address - Phone:253-274-1884
Practice Address - Fax:253-274-1885
Is Sole Proprietor?:No
Enumeration Date:2007-03-13
Last Update Date:2008-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPT000064962251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA7121973Medicaid
WA7121973Medicaid