Provider Demographics
NPI:1285890772
Name:BARNES, RICHARD STEVEN (MPT)
Entity type:Individual
Prefix:
First Name:RICHARD
Middle Name:STEVEN
Last Name:BARNES
Suffix:
Gender:M
Credentials:MPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4040 ORCHARD ST W
Mailing Address - Street 2:SUITE 100
Mailing Address - City:FIRCREST
Mailing Address - State:WA
Mailing Address - Zip Code:98466-6606
Mailing Address - Country:US
Mailing Address - Phone:253-564-1560
Mailing Address - Fax:253-564-4449
Practice Address - Street 1:30 LAKE SHORE PLZ
Practice Address - Street 2:SUITE #102
Practice Address - City:KIRKLAND
Practice Address - State:WA
Practice Address - Zip Code:98033-6175
Practice Address - Country:US
Practice Address - Phone:425-284-1291
Practice Address - Fax:425-284-1692
Is Sole Proprietor?:Yes
Enumeration Date:2008-08-04
Last Update Date:2008-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPT60036588225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist