Healthcare Provider Details

I. General information

NPI: 1255739678
Provider Name (Legal Business Name): MICHELLE PHYSICAL THERAPY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/17/2014
Last Update Date: 04/15/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

649 WINDSOR DR SE
SAMMAMISH WA
98074-3422
US

IV. Provider business mailing address

649 WINDSOR DR SE
SAMMAMISH WA
98074-3422
US

V. Phone/Fax

Practice location:
  • Phone: 425-495-6194
  • Fax:
Mailing address:
  • Phone: 404-780-1116
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2081S0010X
TaxonomySports Medicine (Physical Medicine & Rehabilitation) Physician
License Number
License Number State

VIII. Authorized Official

Name: MS. MICHELLE MURRAY KAPLITA
Title or Position: DIRECTOR/OWNER
Credential: P.T.
Phone: 425-495-6194