Provider Demographics
NPI:1063553758
Name:MONAHAN, JOHN P (PT, DPT)
Entity type:Individual
Prefix:DR
First Name:JOHN
Middle Name:P
Last Name:MONAHAN
Suffix:
Gender:M
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1872
Mailing Address - Street 2:
Mailing Address - City:BOTHELL
Mailing Address - State:WA
Mailing Address - Zip Code:98041-1872
Mailing Address - Country:US
Mailing Address - Phone:425-486-6079
Mailing Address - Fax:425-486-7077
Practice Address - Street 1:18404 102ND AVE NE STE A
Practice Address - Street 2:
Practice Address - City:BOTHELL
Practice Address - State:WA
Practice Address - Zip Code:98011-3380
Practice Address - Country:US
Practice Address - Phone:425-486-6079
Practice Address - Fax:425-486-7077
Is Sole Proprietor?:No
Enumeration Date:2007-02-08
Last Update Date:2023-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA8250225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist