Healthcare Provider Details

I. General information

NPI: 1972784635
Provider Name (Legal Business Name): PHYSICAL THERAPY SPECIALTIES OF SEATTLE P S
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/21/2007
Last Update Date: 04/30/2024
Certification Date: 04/30/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8028 35TH AVE NE
SEATTLE WA
98115-4815
US

IV. Provider business mailing address

8028 35TH AVE NE
SEATTLE WA
98115-4815
US

V. Phone/Fax

Practice location:
  • Phone: 206-524-0124
  • Fax: 206-524-0125
Mailing address:
  • Phone: 206-524-0124
  • Fax: 206-524-0125

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QP2000X
TaxonomyPhysical Therapy Clinic/Center
License Number602257271
License Number StateWA

VIII. Authorized Official

Name: GRETCHEN LUBIN
Title or Position: PRESIDENT
Credential: PT
Phone: 206-524-0124