Individual provider Active NPI

Craig Alan Eakes

  • Physical Therapy Assistant
  • Sequim, WA
National Provider Identifier
1083132377
Registry record updated Sep 6, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy AssistantTaxonomy code 225200000X
License
P160316766 Issued in WA
Practice address
650 W Hemlock St
Sequim, WA 98382-3718
Phone
(360) 582-2400
NPI assigned
Sep 6, 2017
Last updated
Sep 6, 2017By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 6, 2017

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Assistant 225200000X P160316766 WA Primary

Addresses

Primary practice location

650 W Hemlock St
Sequim, WA 98382-3718

Mailing address

62 Chase Rd
Port Townsend, WA 98368-8863
Phone (360) 821-9905

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
P160316766WAMDPhysical Therapy Assistant

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1504656000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1504656000000",
    "number": "1083132377",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "62 CHASE RD",
            "city": "PORT TOWNSEND",
            "state": "WA",
            "postal_code": "983688863",
            "telephone_number": "360-821-9905",
            "fax_number": "360-379-4156"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "650 W HEMLOCK ST",
            "city": "SEQUIM",
            "state": "WA",
            "postal_code": "983823718",
            "telephone_number": "360-582-2400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EAKES",
        "first_name": "CRAIG",
        "middle_name": "ALAN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-09-06",
        "last_updated": "2017-09-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "WA",
            "license": "P160316766",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sequim, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 6, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.