MEDICARE: DIRECT PT, PLLC

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	261QP2000X	Physical Therapy Clinic/Center

General Provider Information

NPI Number	:	1730719691
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DIRECT PT, PLLC

Provider Business Mailing Address
First Line	:	1900 HARVARD AVE E
Second Line	:
City	:	SEATTLE
State	:	WA
Zip	:	98102-4257
Country	:	US
Telephone Number	:	978-877-1259
Fax Number	:

Provider Business Practice Location Address
First Line	:	2510 FAIRVIEW AVE E
Second Line	:
City	:	SEATTLE
State	:	WA
Zip	:	98102-3266
Country	:	US
Telephone Number	:	206-887-3024
Fax Number	:

Authorized Official
Title or Position	:	OWNER, PHYSICAL THERAPIST
Name	:	ERIN FREEMAN
Credential	:	DPT
Telephone Number	:	978-877-1259

Provider Enumeration Date	:	01/20/2020
Last Update Date	:	01/20/2020

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