Healthcare Provider Details

I. General information

NPI: 1497681324
Provider Name (Legal Business Name): TRACTION PHYSICAL THERAPY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/18/2026
Last Update Date: 06/18/2026
Certification Date: 06/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

15730 116TH AVE NE UNIT 112
BOTHELL WA
98011-4184
US

IV. Provider business mailing address

15730 116TH AVE NE UNIT 112
BOTHELL WA
98011-4184
US

V. Phone/Fax

Practice location:
  • Phone: 310-351-7360
  • Fax:
Mailing address:
  • Phone: 310-351-7360
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State

VIII. Authorized Official

Name: EDMOND GORDON
Title or Position: OWNER
Credential: PT, DPT
Phone: 310-351-7360