Provider Demographics
NPI:1992973945
Name:ADVENTURE PHYSICAL THERAPY, PS
Entity type:Organization
Organization Name:ADVENTURE PHYSICAL THERAPY, PS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICAL THERAPIST/PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:SEAN
Authorized Official - Middle Name:ANDRE
Authorized Official - Last Name:CASH
Authorized Official - Suffix:
Authorized Official - Credentials:MPT
Authorized Official - Phone:360-452-3529
Mailing Address - Street 1:111 E 3RD ST STE 2A
Mailing Address - Street 2:
Mailing Address - City:PORT ANGELES
Mailing Address - State:WA
Mailing Address - Zip Code:98362-3020
Mailing Address - Country:US
Mailing Address - Phone:360-452-3529
Mailing Address - Fax:360-452-4043
Practice Address - Street 1:111 E 3RD ST STE 2A
Practice Address - Street 2:
Practice Address - City:PORT ANGELES
Practice Address - State:WA
Practice Address - Zip Code:98362-3020
Practice Address - Country:US
Practice Address - Phone:360-452-3529
Practice Address - Fax:360-452-4043
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-02-12
Last Update Date:2008-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPT00008129261QP2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy