Provider Demographics
NPI:1124591060
Name:EMERALD PHYSICAL THERAPY AND PILATES, PLLC
Entity type:Organization
Organization Name:EMERALD PHYSICAL THERAPY AND PILATES, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:SAMANTHA
Authorized Official - Middle Name:
Authorized Official - Last Name:CHERNAK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:206-775-5454
Mailing Address - Street 1:409 NE 85TH ST
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98115-2926
Mailing Address - Country:US
Mailing Address - Phone:206-775-5454
Mailing Address - Fax:
Practice Address - Street 1:1401 NW 70TH ST
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98117-5340
Practice Address - Country:US
Practice Address - Phone:206-708-6766
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-01-03
Last Update Date:2019-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy