Provider Demographics
NPI:1922766625
Name:POIROT, JOSQUIN J (DPT)
Entity Type:Individual
Prefix:
First Name:JOSQUIN
Middle Name:J
Last Name:POIROT
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 1:6825 BURDEN BLVD STE D
Mailing Address - Street 2:
Mailing Address - City:PASCO
Mailing Address - State:WA
Mailing Address - Zip Code:99301-5633
Mailing Address - Country:US
Mailing Address - Phone:509-416-0406
Mailing Address - Fax:509-545-1112
Practice Address - Street 1:1127 S 2ND AVE STE B
Practice Address - Street 2:
Practice Address - City:WALLA WALLA
Practice Address - State:WA
Practice Address - Zip Code:99362-4118
Practice Address - Country:US
Practice Address - Phone:509-204-2400
Practice Address - Fax:509-545-1112
Is Sole Proprietor?:No
Enumeration Date:2021-11-30
Last Update Date:2021-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPT60602242208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation