Provider Demographics
NPI:1730474461
Name:HOLLANDER, CHARLES SCOTT (DPT)
Entity Type:Individual
Prefix:DR
First Name:CHARLES
Middle Name:SCOTT
Last Name:HOLLANDER
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 1:2016 CLAIRMONT CIR SW
Mailing Address - Street 2:
Mailing Address - City:OLYMPIA
Mailing Address - State:WA
Mailing Address - Zip Code:98512-5518
Mailing Address - Country:US
Mailing Address - Phone:360-305-4957
Mailing Address - Fax:
Practice Address - Street 1:1720 E 67TH ST
Practice Address - Street 2:
Practice Address - City:TACOMA
Practice Address - State:WA
Practice Address - Zip Code:98404-4223
Practice Address - Country:US
Practice Address - Phone:253-474-3563
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-06-10
Last Update Date:2012-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPT601976627225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist