Provider Demographics
NPI:1356351738
Name:PAPINEAU, TIMOTHY LANCE (MPT)
Entity type:Individual
Prefix:
First Name:TIMOTHY
Middle Name:LANCE
Last Name:PAPINEAU
Suffix:
Gender:M
Credentials:MPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 DENNIS ST SW
Mailing Address - Street 2:STE B
Mailing Address - City:TUMWATER
Mailing Address - State:WA
Mailing Address - Zip Code:98501-6523
Mailing Address - Country:US
Mailing Address - Phone:509-927-7827
Mailing Address - Fax:
Practice Address - Street 1:12410 E SINTO AVE
Practice Address - Street 2:#203
Practice Address - City:SPOKANE VALLEY
Practice Address - State:WA
Practice Address - Zip Code:99216-2199
Practice Address - Country:US
Practice Address - Phone:509-927-7827
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-09
Last Update Date:2020-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPT00007847225100000X
IDPT1422225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist