Healthcare Provider Details

I. General information

NPI: 1881639250
Provider Name (Legal Business Name): FRIDAY HARBOR PHYSICAL THERAPY AND REHABILITATION, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/18/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

849 SPRING ST #1
FRIDAY HARBOR WA
98250-9376
US

IV. Provider business mailing address

849 SPRING ST #1
FRIDAY HARBOR WA
98250-9376
US

V. Phone/Fax

Practice location:
  • Phone: 360-370-5226
  • Fax: 360-370-5559
Mailing address:
  • Phone: 360-370-5226
  • Fax: 360-370-5559

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: MRS. SUE ANN JOHNSON
Title or Position: PRESIDENT/OWNER
Credential: OTR/L
Phone: 360-370-5226