Provider Demographics
NPI:1215343314
Name:BALANCE & FLOW PHYSIO LLC
Entity type:Organization
Organization Name:BALANCE & FLOW PHYSIO LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:PAIGE
Authorized Official - Middle Name:
Authorized Official - Last Name:RAFFO
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:805-794-3835
Mailing Address - Street 1:13033 NE 102ND PL
Mailing Address - Street 2:
Mailing Address - City:KIRKLAND
Mailing Address - State:WA
Mailing Address - Zip Code:98033-5246
Mailing Address - Country:US
Mailing Address - Phone:805-794-3835
Mailing Address - Fax:
Practice Address - Street 1:2820 NORTHUP WAY STE 245
Practice Address - Street 2:NORTHUP WEST OFFICE PARK
Practice Address - City:BELLEVUE
Practice Address - State:WA
Practice Address - Zip Code:98004-1419
Practice Address - Country:US
Practice Address - Phone:805-794-3835
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-07-09
Last Update Date:2014-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty