Provider Demographics
NPI:1194101519
Name:EBY, THOMAS (DPT)
Entity type:Individual
Prefix:
First Name:THOMAS
Middle Name:
Last Name:EBY
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1740 LABOUNTY DR
Mailing Address - Street 2:SUITE 7
Mailing Address - City:FERNDALE
Mailing Address - State:WA
Mailing Address - Zip Code:98248-9403
Mailing Address - Country:US
Mailing Address - Phone:360-384-5111
Mailing Address - Fax:360-384-0006
Practice Address - Street 1:1740 LABOUNTY DR
Practice Address - Street 2:SUITE 7
Practice Address - City:FERNDALE
Practice Address - State:WA
Practice Address - Zip Code:98248-9403
Practice Address - Country:US
Practice Address - Phone:360-384-5111
Practice Address - Fax:360-384-0006
Is Sole Proprietor?:No
Enumeration Date:2015-08-07
Last Update Date:2015-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPT60570040225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist