Healthcare Provider Details

I. General information

NPI: 1093876898
Provider Name (Legal Business Name): HIGHLINE PHYSICAL THERAPY GROUP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/13/2006
Last Update Date: 07/08/2026
Certification Date: 07/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

16259 SYLVESTER RD SW SUITE 102
BURIEN WA
98166-3049
US

IV. Provider business mailing address

181 S 333RD ST SUITE 250
FEDERAL WAY WA
98003-7363
US

V. Phone/Fax

Practice location:
  • Phone: 206-242-5186
  • Fax: 206-241-8467
Mailing address:
  • Phone: 253-874-2998
  • Fax: 253-874-3307

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM1300X
TaxonomyMulti-Specialty Clinic/Center
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number StateNULL
# 3
Primary TaxonomyN
Taxonomy Code225700000X
TaxonomyMassage Therapist
License Number
License Number StateNULL
# 4
Primary TaxonomyN
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number
License Number StateNULL
# 5
Primary TaxonomyN
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number
License Number StateNULL

VIII. Authorized Official

Name: MR. CRAIG J KOPET
Title or Position: DIRECTOR
Credential: PT
Phone: 206-242-5186