Provider Demographics
NPI:1316917289
Name:SINYKIN, JOHN (MPT)
Entity type:Individual
Prefix:
First Name:JOHN
Middle Name:
Last Name:SINYKIN
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 1:1617 61ST ST SE
Mailing Address - Street 2:
Mailing Address - City:AUBURN
Mailing Address - State:WA
Mailing Address - Zip Code:98092-8005
Mailing Address - Country:US
Mailing Address - Phone:253-756-7878
Mailing Address - Fax:253-756-9634
Practice Address - Street 1:2102 N. PEARL #203
Practice Address - Street 2:
Practice Address - City:TACOMA
Practice Address - State:WA
Practice Address - Zip Code:98406
Practice Address - Country:US
Practice Address - Phone:253-756-7878
Practice Address - Fax:253-756-9634
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-01-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPT00008223225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WAP28813Medicare UPIN
WAAB20627Medicare ID - Type Unspecified