Provider Demographics
NPI:1215050018
Name:CENTER FOR PHYSICAL THERAPY INC.
Entity type:Organization
Organization Name:CENTER FOR PHYSICAL THERAPY INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ANDREA
Authorized Official - Middle Name:LYNN
Authorized Official - Last Name:HUTTON
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:425-765-2178
Mailing Address - Street 1:21018 SE 24TH ST
Mailing Address - Street 2:
Mailing Address - City:SAMMAMISH
Mailing Address - State:WA
Mailing Address - Zip Code:98075-9623
Mailing Address - Country:US
Mailing Address - Phone:425-765-2178
Mailing Address - Fax:425-427-6287
Practice Address - Street 1:21018 SE 24TH ST
Practice Address - Street 2:
Practice Address - City:SAMMAMISH
Practice Address - State:WA
Practice Address - Zip Code:98075-9623
Practice Address - Country:US
Practice Address - Phone:425-765-2178
Practice Address - Fax:425-427-6287
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-08
Last Update Date:2007-12-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPT00005471261QP2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy
Provider Identifiers
StateIdentifier IDID TypeIssuer
WAG8852162Medicare PIN