Provider Demographics
NPI: | 1750138384 |
---|---|
Name: | BADAJOS, MICHAEL (RT) |
Entity type: | Individual |
Prefix: | |
First Name: | MICHAEL |
Middle Name: | |
Last Name: | BADAJOS |
Suffix: | |
Gender: | M |
Credentials: | RT |
Other - Prefix: | |
Other - First Name: | |
Other - Middle Name: | |
Other - Last Name: | |
Other - Suffix: | |
Other - Last Name Type: | |
Other - Credentials: | |
Mailing Address - Street 1: | 4201 BRIDGEPORT WAY W APT 509A |
Mailing Address - Street 2: | |
Mailing Address - City: | UNIVERSITY PLACE |
Mailing Address - State: | WA |
Mailing Address - Zip Code: | 98466-4349 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 707-652-8872 |
Mailing Address - Fax: | |
Practice Address - Street 1: | 11567 CANTERWOOD BLVD. |
Practice Address - Street 2: | MAIL STOP 53-36 |
Practice Address - City: | GIG HARBOR |
Practice Address - State: | WA |
Practice Address - Zip Code: | 98332 |
Practice Address - Country: | US |
Practice Address - Phone: | 253-530-2366 |
Practice Address - Fax: | |
Is Sole Proprietor?: | No |
Enumeration Date: | 2024-05-01 |
Last Update Date: | 2024-05-01 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization |
---|---|---|---|---|
Yes | 227900000X | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Respiratory Therapist, Registered | |
No | 2279E1000X | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Respiratory Therapist, Registered | Educational |
No | 2279H0200X | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Respiratory Therapist, Registered | Home Health |
No | 2279P1006X | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Respiratory Therapist, Registered | Pulmonary Function Technologist |
No | 2279P3800X | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Respiratory Therapist, Registered | Palliative/Hospice |