Matthew Watanatraibhob, D.P.T.

Primary specialty

Physical TherapistTaxonomy code 225100000X

Practice address

3252 NE 3Rd Ave
Suite 2
Camas, WA 98607-2448

Phone

(360) 835-7427

NPI assigned

Jun 3, 2015

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Northwest Center for Sports Medicine & Physical Therapy, Inc.

  • Physical Therapist
  • Gig Harbor, WA
  • NPI 1982755070
  NPD
• Public Hospital District No 4 King County Washington

  • Critical Access Hospital
  • Snoqualmie, WA
  • NPI 1902846546
  NPD (past)

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

{
    "created_epoch": "1433289600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1447718400000",
    "number": "1740660869",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3252 NE 3RD AVE",
            "address_2": "SUITE 2",
            "city": "CAMAS",
            "state": "WA",
            "postal_code": "986072448",
            "telephone_number": "360-835-7427"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3252 NE 3RD AVE",
            "address_2": "SUITE 2",
            "city": "CAMAS",
            "state": "WA",
            "postal_code": "986072448",
            "telephone_number": "360-835-7427"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WATANATRAIBHOB",
        "first_name": "MATTHEW",
        "name_prefix": "Dr.",
        "credential": "D.P.T.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-06-03",
        "last_updated": "2015-11-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kelsey Wallace, PHARMD
• Sherilyn J Walsh, LMP
• Alicia Walton, LMT
• Ruth Wairimu Wambaa, CNA
• Timothy Warren, LICSW
• Diana Frances Waud-Berry, LMP,LMT
• Heather Webb Ma Cfle
• Richard Wehring
• Vanessa Marie Welch-Pemberton, PSY. D.
• Wellness Institute for Sleep and Health, PLLC

• Physical Therapist in Camas, WA
• Providers in Camas, WA by specialty
• Physical Therapist in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 17, 2015; 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.