Healthcare Provider Details

I. General information

NPI: 1689106411
Provider Name (Legal Business Name): BEND & STRETCH PHYSICAL THERAPY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/30/2017
Last Update Date: 04/12/2021
Certification Date: 04/12/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2332 50TH AVE SW
SEATTLE WA
98116-2309
US

IV. Provider business mailing address

2332 50TH AVE SW
SEATTLE WA
98116-2309
US

V. Phone/Fax

Practice location:
  • Phone: 918-688-4403
  • Fax: 206-430-5059
Mailing address:
  • Phone: 918-688-4403
  • Fax: 206-297-4261

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QP2000X
TaxonomyPhysical Therapy Clinic/Center
License NumberPT60184214
License Number StateWA

VIII. Authorized Official

Name: KATERYNA BAKAY
Title or Position: OWNER
Credential:
Phone: 918-688-4403