Provider Demographics
NPI:1528165610
Name:ARNDT, JOE W (PT)
Entity type:Individual
Prefix:
First Name:JOE
Middle Name:W
Last Name:ARNDT
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 257
Mailing Address - Street 2:
Mailing Address - City:MONTESANO
Mailing Address - State:WA
Mailing Address - Zip Code:98563-0257
Mailing Address - Country:US
Mailing Address - Phone:360-249-4185
Mailing Address - Fax:360-249-4195
Practice Address - Street 1:508 E PIONEER AVE
Practice Address - Street 2:
Practice Address - City:MONTESANO
Practice Address - State:WA
Practice Address - Zip Code:98563-4606
Practice Address - Country:US
Practice Address - Phone:360-249-4185
Practice Address - Fax:360-249-4195
Is Sole Proprietor?:No
Enumeration Date:2006-09-20
Last Update Date:2014-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPT00006495225100000X, 2251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic
No225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA7074511Medicaid
WA650011435OtherMEDICARE RAILROAD #
AR5060OtherREGENCE RIDER
WA131146OtherL & I
WA7074511Medicaid
GAB10989Medicare PIN