Provider Demographics
NPI:1922972900
Name:CORE FOUNDATIONS PHYSICAL THERAPY LLC
Entity type:Organization
Organization Name:CORE FOUNDATIONS PHYSICAL THERAPY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PT
Authorized Official - Prefix:MS
Authorized Official - First Name:MEGHAN
Authorized Official - Middle Name:
Authorized Official - Last Name:PECK
Authorized Official - Suffix:
Authorized Official - Credentials:DPT
Authorized Official - Phone:425-241-0172
Mailing Address - Street 1:1763 S 18TH CIR
Mailing Address - Street 2:
Mailing Address - City:RIDGEFIELD
Mailing Address - State:WA
Mailing Address - Zip Code:98642-7815
Mailing Address - Country:US
Mailing Address - Phone:425-241-0172
Mailing Address - Fax:253-650-6458
Practice Address - Street 1:109 S 65TH AVE STE 105
Practice Address - Street 2:
Practice Address - City:RIDGEFIELD
Practice Address - State:WA
Practice Address - Zip Code:98642-3408
Practice Address - Country:US
Practice Address - Phone:425-241-0172
Practice Address - Fax:253-650-6458
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-10-02
Last Update Date:2025-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy