Healthcare Provider Details

I. General information

NPI: 1245023084
Provider Name (Legal Business Name): BAILEY FJELSTUL DPT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/24/2025
Last Update Date: 05/24/2025
Certification Date: 05/23/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

16261 REDMOND WAY STE 100
REDMOND WA
98052-3833
US

IV. Provider business mailing address

19750 67TH AVE NE
KENMORE WA
98028-3451
US

V. Phone/Fax

Practice location:
  • Phone: 425-881-3001
  • Fax: 425-881-3585
Mailing address:
  • Phone: 425-420-6452
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number70007636
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: