Healthcare Provider Details

I. General information

NPI: 1700016599
Provider Name (Legal Business Name): KATIE LYNN SCHIMIZZI PTA, LMT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/15/2009
Last Update Date: 02/01/2024
Certification Date: 02/01/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3800 MONTLAKE BLVD BOX 354060
SEATTLE WA
98195-0007
US

IV. Provider business mailing address

3800 MONTLAKE BLVD BOX 354060
SEATTLE WA
98195-0007
US

V. Phone/Fax

Practice location:
  • Phone: 206-520-5000
  • Fax:
Mailing address:
  • Phone: 206-520-5000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225200000X
TaxonomyPhysical Therapy Assistant
License NumberP160380414
License Number StateWA
# 2
Primary TaxonomyN
Taxonomy Code225700000X
TaxonomyMassage Therapist
License NumberMA60016944
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: