Healthcare Provider Details

I. General information

NPI: 1487519740
Provider Name (Legal Business Name): ROOT PHYSICAL THERAPY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/18/2025
Last Update Date: 12/18/2025
Certification Date: 12/18/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6332 6TH AVE S
SEATTLE WA
98108-3436
US

IV. Provider business mailing address

6332 6TH AVE S
SEATTLE WA
98108-3436
US

V. Phone/Fax

Practice location:
  • Phone: 843-810-7950
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QP2000X
TaxonomyPhysical Therapy Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State

VIII. Authorized Official

Name: DESIRAE SOLTERO-FARIAS
Title or Position: ADMINISTRATIVE STAFF
Credential:
Phone: 310-867-1767