Provider Demographics
NPI:1669520664
Name:O'NEAL, NEAL D (PT)
Entity type:Individual
Prefix:
First Name:NEAL
Middle Name:D
Last Name:O'NEAL
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16333 NE 80TH ST
Mailing Address - Street 2:
Mailing Address - City:REDMOND
Mailing Address - State:WA
Mailing Address - Zip Code:98052-3820
Mailing Address - Country:US
Mailing Address - Phone:206-856-9305
Mailing Address - Fax:425-869-8329
Practice Address - Street 1:16333 NE 80TH ST
Practice Address - Street 2:
Practice Address - City:REDMOND
Practice Address - State:WA
Practice Address - Zip Code:98052-3820
Practice Address - Country:US
Practice Address - Phone:206-856-9305
Practice Address - Fax:425-869-8329
Is Sole Proprietor?:No
Enumeration Date:2007-01-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPT6893225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist