Healthcare Provider Details

I. General information

NPI: 1396553095
Provider Name (Legal Business Name): ERICK WILLIAM SELLS PT, DPT
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/27/2024
Last Update Date: 08/12/2026
Certification Date: 08/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7900 SE 28TH ST STE 102
MERCER ISLAND WA
98040-2970
US

IV. Provider business mailing address

W4708 LAZY ACRES RD
LA CROSSE WI
54601-2732
US

V. Phone/Fax

Practice location:
  • Phone: 206-232-9045
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number0020304
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: