Provider Demographics
NPI:1306076385
Name:PHYSICAL THERAPY ESSENTIALS
Entity type:Organization
Organization Name:PHYSICAL THERAPY ESSENTIALS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICAL THERAPIST
Authorized Official - Prefix:MRS
Authorized Official - First Name:HILARY
Authorized Official - Middle Name:JANE
Authorized Official - Last Name:CROFT
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:425-644-9778
Mailing Address - Street 1:1750 112TH AVE NE
Mailing Address - Street 2:D-154
Mailing Address - City:BELLEVUE
Mailing Address - State:WA
Mailing Address - Zip Code:98004-3752
Mailing Address - Country:US
Mailing Address - Phone:425-644-9778
Mailing Address - Fax:425-644-6448
Practice Address - Street 1:1750 112TH AVE NE
Practice Address - Street 2:D-154
Practice Address - City:BELLEVUE
Practice Address - State:WA
Practice Address - Zip Code:98004-3752
Practice Address - Country:US
Practice Address - Phone:425-644-9778
Practice Address - Fax:425-644-6448
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-07-23
Last Update Date:2009-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA000104252251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedicGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA1477788792OtherINDIVIDUAL NPI