Healthcare Provider Details

I. General information

NPI: 1487692398
Provider Name (Legal Business Name): SNOHOMISH PHYSICAL THERAPY PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/03/2006
Last Update Date: 09/11/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1830 BICKFORD AVE SUITE 209
SNOHOMISH WA
98290-1749
US

IV. Provider business mailing address

1830 BICKFORD AVE STE 209
SNOHOMISH WA
98290-1750
US

V. Phone/Fax

Practice location:
  • Phone: 360-568-7774
  • Fax: 360-568-7779
Mailing address:
  • Phone: 360-568-7774
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225700000X
TaxonomyMassage Therapist
License Number
License Number StateWA
# 2
Primary TaxonomyN
Taxonomy Code225XH1200X
TaxonomyHand Occupational Therapist
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code261QP2000X
TaxonomyPhysical Therapy Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: RICHARD BINSTEIN
Title or Position: VP/AUTHORIZED OFFICIAL
Credential:
Phone: 713-297-7000