Healthcare Provider Details

I. General information

NPI: 1326634981
Provider Name (Legal Business Name): STEPHEN COOMBS PT, DPT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/17/2020
Last Update Date: 01/17/2022
Certification Date: 01/17/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1100 9TH AVE
SEATTLE WA
98101-2756
US

IV. Provider business mailing address

1100 9TH AVE M4-PFS
SEATTLE WA
98101
US

V. Phone/Fax

Practice location:
  • Phone: 206-223-6999
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2251S0007X
TaxonomySports Physical Therapist
License Number070.025215
License Number StateIL
# 2
Primary TaxonomyY
Taxonomy Code2251S0007X
TaxonomySports Physical Therapist
License NumberPT61061339
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: