Provider Demographics
NPI:1184611345
Name:LOOMIS, LARRY L (DPT, OCS, FAFS)
Entity type:Individual
Prefix:MR
First Name:LARRY
Middle Name:L
Last Name:LOOMIS
Suffix:
Gender:M
Credentials:DPT, OCS, FAFS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4706 SCENIC DR
Mailing Address - Street 2:
Mailing Address - City:YAKIMA
Mailing Address - State:WA
Mailing Address - Zip Code:98908-2221
Mailing Address - Country:US
Mailing Address - Phone:509-423-7007
Mailing Address - Fax:509-423-7384
Practice Address - Street 1:4706 SCENIC DR
Practice Address - Street 2:
Practice Address - City:YAKIMA
Practice Address - State:WA
Practice Address - Zip Code:98908-2221
Practice Address - Country:US
Practice Address - Phone:509-423-7007
Practice Address - Fax:509-423-7384
Is Sole Proprietor?:No
Enumeration Date:2005-10-03
Last Update Date:2020-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPT000055922251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic