Healthcare Provider Details

I. General information

NPI: 1013306992
Provider Name (Legal Business Name): EIGHTH FIELD PLCC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/15/2015
Last Update Date: 01/15/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2915 E MADISON ST SUITE 205
SEATTLE WA
98112-4265
US

IV. Provider business mailing address

8250 LATONA AVE NE
SEATTLE WA
98115-4055
US

V. Phone/Fax

Practice location:
  • Phone: 206-852-5878
  • Fax: 206-522-4749
Mailing address:
  • Phone: 206-852-5878
  • Fax: 206-522-4749

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QP2000X
TaxonomyPhysical Therapy Clinic/Center
License NumberPT0005158
License Number StateWA

VIII. Authorized Official

Name: MS. KATHERINE SHIZUE YANO
Title or Position: OWNER/MANAGER
Credential: PT
Phone: 206-852-5878