Provider Demographics
NPI:1699739102
Name:WALTIER, JOSH A (MPT)
Entity type:Individual
Prefix:
First Name:JOSH
Middle Name:A
Last Name:WALTIER
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 1:790 REMINGTON BLVD
Mailing Address - Street 2:
Mailing Address - City:BOLINGBROOK
Mailing Address - State:IL
Mailing Address - Zip Code:60440-4909
Mailing Address - Country:US
Mailing Address - Phone:630-296-2223
Mailing Address - Fax:630-759-9510
Practice Address - Street 1:600 UNIVERSITY ST
Practice Address - Street 2:STE 818
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98101-1176
Practice Address - Country:US
Practice Address - Phone:206-957-3336
Practice Address - Fax:206-957-1349
Is Sole Proprietor?:No
Enumeration Date:2006-04-12
Last Update Date:2015-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPT00009127225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA0291629OtherDEPT. OF LABOR AND INDUSTRIES
WA170170OtherDEPT OF LABOR & INDUSTRIE
WAP00014672OtherRAILROAD MEDICARE
WA9752WAOtherREGENCE BLUE SHIELD
WA8337073Medicaid
WA8934866OtherCRIME VICTIME
WA8934866OtherCRIME VICTIME
WAAB37272Medicare ID - Type UnspecifiedPIERCE COUNTY