Provider Demographics
NPI:1447553516
Name:EARLEY, GEORGE DAVID IV (RRT RCP CPFT)
Entity type:Individual
Prefix:
First Name:GEORGE
Middle Name:DAVID
Last Name:EARLEY
Suffix:IV
Gender:M
Credentials:RRT RCP CPFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16203 1ST AVE S
Mailing Address - Street 2:
Mailing Address - City:BURIEN
Mailing Address - State:WA
Mailing Address - Zip Code:98148-1402
Mailing Address - Country:US
Mailing Address - Phone:910-703-0928
Mailing Address - Fax:
Practice Address - Street 1:16203 1ST AVE S
Practice Address - Street 2:
Practice Address - City:BURIEN
Practice Address - State:WA
Practice Address - Zip Code:98148-1402
Practice Address - Country:US
Practice Address - Phone:910-703-0928
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-12-13
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCA-3410227900000X
WALR606224792279P1004X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2279P1004XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRespiratory Therapist, RegisteredPulmonary Diagnostics
No227900000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRespiratory Therapist, Registered