Healthcare Provider Details

I. General information

NPI: 1659258085
Provider Name (Legal Business Name): ENERTIA PHYSICAL THERAPY PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/18/2025
Last Update Date: 08/18/2025
Certification Date: 08/18/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12304 32ND AVE NE
SEATTLE WA
98125-5506
US

IV. Provider business mailing address

23906 46TH AVE W
MOUNTLAKE TERRACE WA
98043-5739
US

V. Phone/Fax

Practice location:
  • Phone: 206-504-3190
  • Fax:
Mailing address:
  • Phone: 206-228-2527
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QP2000X
TaxonomyPhysical Therapy Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: DR. DANIELLE AXTELL
Title or Position: PHYSICAL THERAPIST / OWNER
Credential: PT, DPT
Phone: 206-228-2527