Healthcare Provider Details

I. General information

NPI: 1700108289
Provider Name (Legal Business Name): OUTPATIENT PHYSICAL THERAPY & SPORTS REHABILITATION INC PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/24/2010
Last Update Date: 01/14/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

27005 168TH PL SE STE 200
COVINGTON WA
98042-4902
US

IV. Provider business mailing address

26837 MAPLE VALLEY BLACK DIAMOND RD SE STE 201
MAPLE VALLEY WA
98038-9917
US

V. Phone/Fax

Practice location:
  • Phone: 253-639-4788
  • Fax:
Mailing address:
  • Phone: 425-413-4427
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number
License Number State

VIII. Authorized Official

Name: DAN B STEELE
Title or Position: OWNER
Credential: PT
Phone: 425-413-4427