Healthcare Provider Details

I. General information

NPI: 1356052062
Provider Name (Legal Business Name): AMBITION PHYSICAL THERAPY AND FITNESS, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/13/2022
Last Update Date: 12/13/2022
Certification Date: 12/13/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3209 N ARGONNE RD
MILLWOOD WA
99212-2061
US

IV. Provider business mailing address

9413 E PRINCETON AVE
SPOKANE WA
99206-4462
US

V. Phone/Fax

Practice location:
  • Phone: 509-999-7290
  • Fax: 509-290-5246
Mailing address:
  • Phone: 509-999-7290
  • Fax: 509-290-5246

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: JAMI BEAN
Title or Position: PHYSICAL THERAPIST/OWNER
Credential: DPT
Phone: 509-999-7290