Healthcare Provider Details

I. General information

NPI: 1538359369
Provider Name (Legal Business Name): MITCHELL G OWENS JR. M.S.P.T.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/27/2007
Last Update Date: 08/20/2025
Certification Date: 08/20/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2214 N 56TH ST
SEATTLE WA
98103-6204
US

IV. Provider business mailing address

2214 N 56TH ST
SEATTLE WA
98103-6204
US

V. Phone/Fax

Practice location:
  • Phone: 206-588-0855
  • Fax: 206-588-0397
Mailing address:
  • Phone: 206-588-0855
  • Fax: 206-588-0397

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2251X0800X
TaxonomyOrthopedic Physical Therapist
License NumberPT00009618
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: