Provider Demographics
NPI:1962597070
Name:MATEKEL, ROBERT L (PT, DSC, OCS)
Entity type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:L
Last Name:MATEKEL
Suffix:
Gender:M
Credentials:PT, DSC, OCS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17002 94TH AVENUE EAST
Mailing Address - Street 2:
Mailing Address - City:PUYALLUP
Mailing Address - State:WA
Mailing Address - Zip Code:98375
Mailing Address - Country:US
Mailing Address - Phone:253-770-6950
Mailing Address - Fax:
Practice Address - Street 1:9040 FITZSIMMONS DRIVE
Practice Address - Street 2:ATTN: MCHJ-PT
Practice Address - City:TACOMA
Practice Address - State:WA
Practice Address - Zip Code:98431
Practice Address - Country:US
Practice Address - Phone:253-968-0780
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT119978-24012251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic