MEDICARE: LYNDEN FAMILY PHYSICAL THERAPY PS INC.

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

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	G8857930	OTHER	WA	MEDICARE ID-PIN
2	GAB14762	OTHER	WA	MEDICARE ID-PIN
3	GAB14760	OTHER	WA	MEDICARE ID-PIN

General Provider Information

NPI Number	:	1871578682
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LYNDEN FAMILY PHYSICAL THERAPY PS INC.

Provider Business Mailing Address
First Line	:	1824 FRONT STREET, STE A
Second Line	:
City	:	LYNDEN
State	:	WA
Zip	:	98264-1729
Country	:	US
Telephone Number	:	360-354-0585
Fax Number	:	360-354-1098

Provider Business Practice Location Address
First Line	:	1824 FRONT STREET, STE A
Second Line	:
City	:	LYNDEN
State	:	WA
Zip	:	98264
Country	:	US
Telephone Number	:	360-354-0585
Fax Number	:	360-354-1098

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. STEVEN KENNETH KORTHUIS
Credential	:	DPT
Telephone Number	:	360-354-0585

Provider Enumeration Date	:	12/14/2005
Last Update Date	:	12/01/2025

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Directions to “LYNDEN FAMILY PHYSICAL THERAPY PS INC. ” Practice Location

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