Provider Demographics
NPI:1871509497
Name:PRONK, JOSEPH A (PT)
Entity Type:Individual
Prefix:MR
First Name:JOSEPH
Middle Name:A
Last Name:PRONK
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 6908
Mailing Address - Street 2:
Mailing Address - City:BELLEVUE
Mailing Address - State:WA
Mailing Address - Zip Code:98008-0908
Mailing Address - Country:US
Mailing Address - Phone:425-576-8180
Mailing Address - Fax:425-828-7840
Practice Address - Street 1:10510 NORTHUP WAY
Practice Address - Street 2:SUITE 140
Practice Address - City:KIRKLAND
Practice Address - State:WA
Practice Address - Zip Code:98033-7901
Practice Address - Country:US
Practice Address - Phone:425-576-8180
Practice Address - Fax:425-828-7840
Is Sole Proprietor?:No
Enumeration Date:2006-08-01
Last Update Date:2008-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPT00002929225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist