Mountlake Sports & Physical Therapy Ps
LBN: Mountlake Sports & Physical Therapy Ps
Mountlake Sports & Physical Therapy Ps is an health care organization with primary practice located at 9505 19Th Ave Se 101, Everett WA 98208-3853. The organization recently has 2 registered licenses in different health care specialties including Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapist, Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Massage Therapist. Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapist is the primary health care specialty.
Mountlake Sports & Physical Therapy Ps can be contacted via phone (425) 379-8120, or through Malijan, Jamie via phone (425) 379-8120.
Contact Information
Primary practice address
9505 19Th Ave Se 101
Everett WA 98208-3853
Phone: (425) 379-8120
Fax: (425) 338-1789
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapist | 225100000X | PT00003917 | Washington |
| Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapist | 225100000X | PT60178380 | Washington |
| Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Massage Therapist | 225700000X | MA00018299 | Washington |
| Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Massage Therapist | 225700000X | MA00015079 | Washington |
Profile Details
| NPI number | 1528331402 |
|---|---|
| LBN Legal business name | Mountlake Sports & Physical Therapy Ps |
| DBA Doing business as | |
| Authorized official | Malijan, Jamie |
| Entity | Organization |
| Organization subpart 1 | No |
| Enumeration date | Feb 22nd, 2012 |
| Last updated | Feb 22nd, 2012 - about 12 years ago |
1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1528331402 | NPPES |
| Washington | MEDICAID | 7084650 | |
| Washington | Other | 0151396 |
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