Healthcare Provider Details

I. General information

NPI: 1558436923
Provider Name (Legal Business Name): FACTORIA SPORTS AND SPINE PHYSICAL THERAPY P S
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/21/2006
Last Update Date: 11/17/2025
Certification Date: 11/17/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14100 SE 36TH ST SUITE 210
BELLEVUE WA
98006-1657
US

IV. Provider business mailing address

14100 SE 36TH ST SUITE 210
BELLEVUE WA
98006-1657
US

V. Phone/Fax

Practice location:
  • Phone: 425-653-7100
  • Fax: 425-653-7109
Mailing address:
  • Phone: 425-653-7100
  • Fax: 425-653-7109

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberPT00005342
License Number StateWA

VIII. Authorized Official

Name: JOSHUA DOUGLAS FIELD
Title or Position: PRESIDENT/OWNER
Credential: PT
Phone: 425-653-7100