Healthcare Provider Details

I. General information

NPI: 1700721289
Provider Name (Legal Business Name): BEYOND BASELINE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/21/2026
Last Update Date: 04/21/2026
Certification Date: 04/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4026 STONE WAY N UNIT 303
SEATTLE WA
98103-8028
US

IV. Provider business mailing address

4026 STONE WAY N UNIT 303
SEATTLE WA
98103-8028
US

V. Phone/Fax

Practice location:
  • Phone: 630-776-1275
  • Fax:
Mailing address:
  • Phone: 630-776-1275
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: CARLI THERESE MILLARD
Title or Position: OWNER/PHYSICAL THERAPIST
Credential: PT, DPT
Phone: 630-776-1275