Provider Demographics
NPI:1972031771
Name:KOLLAR, VICTOR (PT, DPT)
Entity Type:Individual
Prefix:
First Name:VICTOR
Middle Name:
Last Name:KOLLAR
Suffix:
Gender:M
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6710 108TH AVE NE
Mailing Address - Street 2:
Mailing Address - City:KIRKLAND
Mailing Address - State:WA
Mailing Address - Zip Code:98033-7050
Mailing Address - Country:US
Mailing Address - Phone:425-979-7445
Mailing Address - Fax:425-947-8540
Practice Address - Street 1:6710 108TH AVE NE
Practice Address - Street 2:
Practice Address - City:KIRKLAND
Practice Address - State:WA
Practice Address - Zip Code:98033-7050
Practice Address - Country:US
Practice Address - Phone:425-979-7445
Practice Address - Fax:425-947-8540
Is Sole Proprietor?:Yes
Enumeration Date:2017-05-24
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPT60745522225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WAPT60745522OtherDEPARTMENT OF HEALTH