Provider Demographics
NPI:1427482991
Name:MENDOZA, RHENAND (PT, DPT)
Entity type:Individual
Prefix:DR
First Name:RHENAND
Middle Name:
Last Name:MENDOZA
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 1:1415 NE 153RD ST
Mailing Address - Street 2:UNIT A
Mailing Address - City:SHORELINE
Mailing Address - State:WA
Mailing Address - Zip Code:98155-7141
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:7500 212TH ST SW STE 112
Practice Address - Street 2:
Practice Address - City:EDMONDS
Practice Address - State:WA
Practice Address - Zip Code:98026-7615
Practice Address - Country:US
Practice Address - Phone:425-278-9705
Practice Address - Fax:425-984-9176
Is Sole Proprietor?:No
Enumeration Date:2013-09-03
Last Update Date:2022-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPT60148245225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist