Provider Demographics
NPI:1801369368
Name:MERRITT, TREVOR FRANKLIN (ATC)
Entity Type:Individual
Prefix:
First Name:TREVOR
Middle Name:FRANKLIN
Last Name:MERRITT
Suffix:
Gender:M
Credentials:ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4407 183RD AVE E
Mailing Address - Street 2:
Mailing Address - City:LAKE TAPPS
Mailing Address - State:WA
Mailing Address - Zip Code:98391-6728
Mailing Address - Country:US
Mailing Address - Phone:253-303-2748
Mailing Address - Fax:
Practice Address - Street 1:12 SEAHAWKS WAY
Practice Address - Street 2:
Practice Address - City:RENTON
Practice Address - State:WA
Practice Address - Zip Code:98056-1572
Practice Address - Country:US
Practice Address - Phone:253-303-2748
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-01-08
Last Update Date:2020-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer