Healthcare Provider Details

I. General information

NPI: 1144272980
Provider Name (Legal Business Name): JUDY MARIE ADAMS MPT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/17/2006
Last Update Date: 03/31/2021
Certification Date: 03/31/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1880 POTTERY AVE STE 100 KITSAP PHYSICAL THERAPY
PORT ORCHARD WA
98366
US

IV. Provider business mailing address

950 PACIFIC AVE STE 900
TACOMA WA
98402-4425
US

V. Phone/Fax

Practice location:
  • Phone: 360-895-9090
  • Fax: 360-895-9089
Mailing address:
  • Phone: 253-274-4600
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberPT00005551
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: