Healthcare Provider Details

I. General information

NPI: 1902420821
Provider Name (Legal Business Name): REAL TIME PHYSICAL THERAPY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/05/2020
Last Update Date: 09/24/2020
Certification Date: 09/18/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3710 27TH PL W APT 205
SEATTLE WA
98199-2055
US

IV. Provider business mailing address

3710 27TH PL W APT 205
SEATTLE WA
98199-2055
US

V. Phone/Fax

Practice location:
  • Phone: 206-594-3232
  • Fax: 206-415-8634
Mailing address:
  • Phone: 206-594-3232
  • Fax: 206-415-8634

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QP2000X
TaxonomyPhysical Therapy Clinic/Center
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code2251C2600X
TaxonomyCardiopulmonary Physical Therapist
License Number
License Number StateNULL
# 3
Primary TaxonomyN
Taxonomy Code2251E1200X
TaxonomyErgonomics Physical Therapist
License Number
License Number StateNULL
# 4
Primary TaxonomyY
Taxonomy Code2251G0304X
TaxonomyGeriatric Physical Therapist
License Number
License Number StateNULL
# 5
Primary TaxonomyN
Taxonomy Code2251N0400X
TaxonomyNeurology Physical Therapist
License Number
License Number StateNULL
# 6
Primary TaxonomyN
Taxonomy Code2251X0800X
TaxonomyOrthopedic Physical Therapist
License Number
License Number StateNULL

VIII. Authorized Official

Name: DR. SHARON E MCCALLUM
Title or Position: OWNER, PT, DPT
Credential: DPT
Phone: 206-594-3232