MEDICARE: NORTHWEST THERAPY CENTER, 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	225400000X	Rehabilitation Practitioner	602227469	WA
2	225100000X	Physical Therapist

General Provider Information

NPI Number	:	1508972894
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	NORTHWEST THERAPY CENTER, LLC

Provider Business Mailing Address
First Line	:	320 NE 97TH ST. STE B
Second Line	:
City	:	SEATTLE
State	:	WA
Zip	:	98115
Country	:	US
Telephone Number	:	206-525-1010
Fax Number	:	206-523-9101

Provider Business Practice Location Address
First Line	:	320 NE 97TH ST.
Second Line	:	STE B
City	:	SEATTLE
State	:	WA
Zip	:	98115
Country	:	US
Telephone Number	:	206-525-1010
Fax Number	:	206-523-1330

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MRS. AZMINA KANJI
Credential	:
Telephone Number	:	818-758-2673

Provider Enumeration Date	:	08/21/2006
Last Update Date	:	12/17/2025

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