Provider Demographics
NPI:1023133840
Name:BAUS, DAVID M (PT)
Entity type:Individual
Prefix:
First Name:DAVID
Middle Name:M
Last Name:BAUS
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13509 127TH AVE SE
Mailing Address - Street 2:
Mailing Address - City:SNOHOMISH
Mailing Address - State:WA
Mailing Address - Zip Code:98290-6734
Mailing Address - Country:US
Mailing Address - Phone:360-568-1195
Mailing Address - Fax:
Practice Address - Street 1:17000 140TH AVE NE
Practice Address - Street 2:303
Practice Address - City:WOODINVILLE
Practice Address - State:WA
Practice Address - Zip Code:98072-6928
Practice Address - Country:US
Practice Address - Phone:425-481-1744
Practice Address - Fax:425-483-1774
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPT00002686225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA8333098Medicaid
WAAB07722Medicare ID - Type Unspecified