Provider Demographics
NPI:1154580496
Name:MORGAN, ROBERT BRUCE (PT, GCS)
Entity type:Individual
Prefix:
First Name:ROBERT
Middle Name:BRUCE
Last Name:MORGAN
Suffix:
Gender:M
Credentials:PT, GCS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:220 W WENTWORTH RD
Mailing Address - Street 2:
Mailing Address - City:ROSALIA
Mailing Address - State:WA
Mailing Address - Zip Code:99170-9755
Mailing Address - Country:US
Mailing Address - Phone:509-951-1679
Mailing Address - Fax:
Practice Address - Street 1:1150 W FAIRVIEW ST
Practice Address - Street 2:
Practice Address - City:COLFAX
Practice Address - State:WA
Practice Address - Zip Code:99111-9580
Practice Address - Country:US
Practice Address - Phone:509-397-4603
Practice Address - Fax:509-397-9214
Is Sole Proprietor?:No
Enumeration Date:2008-06-02
Last Update Date:2017-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPT00003530225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist