Healthcare Provider Details

I. General information

NPI: 1063370872
Provider Name (Legal Business Name): MOVE MOUNTAINS PHYSICAL THERAPY, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/12/2026
Last Update Date: 01/12/2026
Certification Date: 01/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4807 178TH AVE E
LAKE TAPPS WA
98391-9126
US

IV. Provider business mailing address

4807 178TH AVE E
LAKE TAPPS WA
98391-9126
US

V. Phone/Fax

Practice location:
  • Phone: 770-561-9313
  • Fax: 866-610-1274
Mailing address:
  • Phone: 770-561-9313
  • Fax: 866-610-1274

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QP2000X
TaxonomyPhysical Therapy Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: DR. LACIE HOWELL LEWANDOWSKI
Title or Position: OWNER/ PHYSICAL THERAPIST
Credential: PT
Phone: 770-561-9313