Pedersen, George
Pedersen, George is an sole proprietor health care provider with primary practice located at 553 Roosevelt Ave Suite 101, Enumclaw WA 98022-2990. He recently has only one registered license in Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapist, which is considered as his primary health care specialty. Pedersen, George can be contacted via phone (360) 825-1540.Contact Information
Primary practice address
553 Roosevelt Ave Suite 101
Enumclaw WA 98022-2990
Phone: (360) 825-1540
Fax: (360) 825-7434
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapist | 225100000X |
Profile Details
| NPI number | 1982771580 |
|---|---|
| LBN Legal business name | Pedersen, George |
| Credentials | Master of Physical Therapy (MPT) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Nov 29th, 2006 |
| Last updated | Nov 29th, 2012 - about 14 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1982771580 | NPPES |
| Washington | MEDICAID | 8346462 |
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