Provider Demographics
NPI:1780619239
Name:PFISTER, WILLIAM R JR (PT)
Entity type:Individual
Prefix:MR
First Name:WILLIAM
Middle Name:R
Last Name:PFISTER
Suffix:JR
Gender:M
Credentials:PT
Other - Prefix:
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Mailing Address - Street 1:11711 NE 12TH ST STE 3A
Mailing Address - Street 2:
Mailing Address - City:BELLEVUE
Mailing Address - State:WA
Mailing Address - Zip Code:98005-2461
Mailing Address - Country:US
Mailing Address - Phone:425-450-9474
Mailing Address - Fax:425-452-0704
Practice Address - Street 1:1707 3RD ST SE
Practice Address - Street 2:
Practice Address - City:PUYALLUP
Practice Address - State:WA
Practice Address - Zip Code:98372
Practice Address - Country:US
Practice Address - Phone:253-841-3041
Practice Address - Fax:253-841-3061
Is Sole Proprietor?:No
Enumeration Date:2006-07-12
Last Update Date:2018-06-22
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
WAPT0000997225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA8445173Medicaid
WA8858488Medicare ID - Type Unspecified