Provider Demographics
NPI:1649670266
Name:STEFFAN, DUSTIN (DPT)
Entity type:Individual
Prefix:
First Name:DUSTIN
Middle Name:
Last Name:STEFFAN
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 1:190 W DAYTON ST STE 202
Mailing Address - Street 2:
Mailing Address - City:EDMONDS
Mailing Address - State:WA
Mailing Address - Zip Code:98020-7221
Mailing Address - Country:US
Mailing Address - Phone:425-776-3348
Mailing Address - Fax:425-776-3348
Practice Address - Street 1:190 W DAYTON ST STE 202
Practice Address - Street 2:
Practice Address - City:EDMONDS
Practice Address - State:WA
Practice Address - Zip Code:98020-7221
Practice Address - Country:US
Practice Address - Phone:425-776-3348
Practice Address - Fax:425-776-3348
Is Sole Proprietor?:No
Enumeration Date:2014-09-02
Last Update Date:2014-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPT 60478414225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist