Healthcare Provider Details

I. General information

NPI: 1700534187
Provider Name (Legal Business Name): ZACHARY FOX PT, DPT, ATC
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/14/2022
Last Update Date: 01/04/2026
Certification Date: 01/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3800 MONTLAKE BLVD
SEATTLE WA
98195-0007
US

IV. Provider business mailing address

3800 MONTLAKE BLVD
SEATTLE WA
98195-0007
US

V. Phone/Fax

Practice location:
  • Phone: 717-424-2109
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2255A2300X
TaxonomyAthletic Trainer
License Number70016445
License Number StateWA
# 2
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number70016444
License Number StateWA
# 3
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberPT029926
License Number StatePA
# 4
Primary TaxonomyN
Taxonomy Code2255A2300X
TaxonomyAthletic Trainer
License NumberRT007954
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: