MEDICARE: BEND TO MEND PHYSICAL THERAPY, LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225100000X	Physical Therapist	PT00009461	WA

General Provider Information

NPI Number	:	1346526563
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BEND TO MEND PHYSICAL THERAPY, LLC

Provider Business Mailing Address
First Line	:	1325 N LUCAS PL
Second Line	:
City	:	SEATTLE
State	:	WA
Zip	:	98103-8153
Country	:	US
Telephone Number	:	206-334-1824
Fax Number	:	206-784-7471

Provider Business Practice Location Address
First Line	:	5409 17TH AVE NW
Second Line	:
City	:	SEATTLE
State	:	WA
Zip	:	98107-3818
Country	:	US
Telephone Number	:	206-334-1824
Fax Number	:

Authorized Official
Title or Position	:	PHYSICAL THERAPIST
Name	:	MRS. CAROLINE PAIGE KAPLAN
Credential	:	MPT, LMP
Telephone Number	:	206-334-1824

Provider Enumeration Date	:	11/02/2011
Last Update Date	:	02/01/2012

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