Provider Demographics
NPI:1962661827
Name:NAKATANI, DALE TORAICHI (PTA)
Entity type:Individual
Prefix:
First Name:DALE
Middle Name:TORAICHI
Last Name:NAKATANI
Suffix:
Gender:M
Credentials:PTA
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 31638
Mailing Address - Street 2:
Mailing Address - City:BELLINGHAM
Mailing Address - State:WA
Mailing Address - Zip Code:98228-3638
Mailing Address - Country:US
Mailing Address - Phone:360-714-1918
Mailing Address - Fax:
Practice Address - Street 1:4680 CORDATA PKWY
Practice Address - Street 2:
Practice Address - City:BELLINGHAM
Practice Address - State:WA
Practice Address - Zip Code:98226-8038
Practice Address - Country:US
Practice Address - Phone:360-714-1918
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-06-05
Last Update Date:2008-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant