Provider Demographics
NPI:1134959596
Name:FELIPE, JUSTICE DANIEL (DPT, CSCS)
Entity type:Individual
Prefix:
First Name:JUSTICE
Middle Name:DANIEL
Last Name:FELIPE
Suffix:
Gender:M
Credentials:DPT, CSCS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5620 RAINIER AVE S # 102
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98118-2498
Mailing Address - Country:US
Mailing Address - Phone:206-535-8061
Mailing Address - Fax:206-535-8064
Practice Address - Street 1:4351 15TH AVE S # 102
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98108-1474
Practice Address - Country:US
Practice Address - Phone:206-620-1589
Practice Address - Fax:206-629-6052
Is Sole Proprietor?:No
Enumeration Date:2024-08-01
Last Update Date:2024-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPT61580933225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist