Provider Demographics
NPI:1730262635
Name:EATON, MORGAN D (MA, PT)
Entity type:Individual
Prefix:
First Name:MORGAN
Middle Name:D
Last Name:EATON
Suffix:
Gender:M
Credentials:MA, PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:875 SWIFT BLVD
Mailing Address - Street 2:
Mailing Address - City:RICHLAND
Mailing Address - State:WA
Mailing Address - Zip Code:99352-3592
Mailing Address - Country:US
Mailing Address - Phone:509-943-8977
Mailing Address - Fax:509-943-6151
Practice Address - Street 1:5210 N ROAD 68 STE F
Practice Address - Street 2:
Practice Address - City:PASCO
Practice Address - State:WA
Practice Address - Zip Code:99301-9276
Practice Address - Country:US
Practice Address - Phone:509-543-7377
Practice Address - Fax:509-543-7677
Is Sole Proprietor?:No
Enumeration Date:2006-10-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPT00006101225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA7376430OtherAETNA
WA8321416Medicaid
WA8560EAOtherREGENCE INS. PLAN
WA22386851601OtherCHPW
WA8931094OtherCVCP
WA4366OtherGROUP HEALTH
WA0162949OtherL AND I
WA8931094OtherCVCP
WA8321416Medicaid