Basic Information
| Provider Information | |||||||||
| NPI: | 1093891541 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | MCVEIN | ||||||||
| FirstName: | JOSEPH | ||||||||
| MiddleName: | D | ||||||||
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| Credential: | BSPT | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 2170 | ||||||||
| Address2: | |||||||||
| City: | SUMNER | ||||||||
| State: | WA | ||||||||
| PostalCode: | 983900480 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2538402313 | ||||||||
| FaxNumber: | 2538406340 | ||||||||
| Practice Location | |||||||||
| Address1: | 6985 COAL CREEK PKWY SE | ||||||||
| Address2: | |||||||||
| City: | NEWCASTLE | ||||||||
| State: | WA | ||||||||
| PostalCode: | 980593136 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4253780500 | ||||||||
| FaxNumber: | 4253788168 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 10/27/2006 | ||||||||
| LastUpdateDate: | 04/24/2008 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 225100000X | PT00005111 | WA | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist |
ID Information
| ID | Type | State | Issuer | Description | 650018965 | 01 | WA | RAILROAD MEDICARE | OTHER | 8935152 | 01 | WA | CRIME VICTIMS | OTHER | 7861MC | 01 | WA | REGENCE BLUE SHIELD | OTHER | A006 | 01 | WA | TRICARE | OTHER | 8324444 | 05 | WA | MEDICAID | 139665 | 01 | WA | DEPT OF LABOR & INDUSTRY | OTHER |