Healthcare Provider Details

I. General information

NPI: 1184140246
Provider Name (Legal Business Name): BESPOKE TREATMENTS SEATTLE PT PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/20/2017
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1124 COLUMBIA ST
SEATTLE WA
98104-2026
US

IV. Provider business mailing address

1124 COLUMBIA ST
SEATTLE WA
98104-2026
US

V. Phone/Fax

Practice location:
  • Phone: 646-596-7427
  • Fax: 646-358-3443
Mailing address:
  • Phone: 646-596-7427
  • Fax: 646-358-3443

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: DANIEL GIORDANO
Title or Position: OWNER
Credential: DPT
Phone: 646-596-7427