Healthcare Provider Details

I. General information

NPI: 1710330378
Provider Name (Legal Business Name): THERAPY MANAGEMENT SERVICES, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/19/2016
Last Update Date: 03/17/2022
Certification Date: 03/17/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

15600 NE 8TH ST STE A3
BELLEVUE WA
98008-3917
US

IV. Provider business mailing address

11711 NE 12TH ST STE 3A
BELLEVUE WA
98005-2461
US

V. Phone/Fax

Practice location:
  • Phone: 425-502-7081
  • Fax: 425-679-6902
Mailing address:
  • Phone: 425-450-9474
  • Fax: 425-452-0704

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code133N00000X
TaxonomyNutritionist
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State

VIII. Authorized Official

Name: DWAN DIAZ
Title or Position: CREDENTIALING COORDINATOR
Credential:
Phone: 425-450-9474