Provider Demographics
NPI: | 1245454453 |
---|---|
Name: | ARNETT, JAMES LARRY (PT LAC) |
Entity type: | Individual |
Prefix: | MR |
First Name: | JAMES |
Middle Name: | LARRY |
Last Name: | ARNETT |
Suffix: | |
Gender: | M |
Credentials: | PT LAC |
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 60241 |
Mailing Address - Street 2: | |
Mailing Address - City: | SEATTLE |
Mailing Address - State: | WA |
Mailing Address - Zip Code: | 98160-0241 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 206-546-0249 |
Mailing Address - Fax: | 206-535-8719 |
Practice Address - Street 1: | 835 NW 190TH ST |
Practice Address - Street 2: | |
Practice Address - City: | SHORELINE |
Practice Address - State: | WA |
Practice Address - Zip Code: | 98177-2626 |
Practice Address - Country: | US |
Practice Address - Phone: | 206-546-0249 |
Practice Address - Fax: | 206-533-8719 |
Is Sole Proprietor?: | No |
Enumeration Date: | 2007-04-12 |
Last Update Date: | 2025-09-11 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Licenses
State | License ID | Taxonomies |
---|---|---|
WA | AC00000557 | 171100000X |
WA | PT00002016 | 225100000X |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization |
---|---|---|---|---|
Yes | 171100000X | Other Service Providers | Acupuncturist | |
No | 225100000X | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist |
Provider Identifiers
State | Identifier ID | ID Type | Issuer |
---|---|---|---|
Q47852 | Medicare UPIN | ||
WA | 8854565 | Medicare ID - Type Unspecified |