Healthcare Provider Details

I. General information

NPI: 1295207983
Provider Name (Legal Business Name): THERAPY MANAGEMENT SERVICES, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/19/2018
Last Update Date: 06/21/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4704 BRIDGEPORT WAY W
UNIVERSITY PLACE WA
98466-4204
US

IV. Provider business mailing address

915 118TH AVE SE STE 110
BELLEVUE WA
98005-3875
US

V. Phone/Fax

Practice location:
  • Phone: 844-708-7982
  • Fax: 425-968-1454
Mailing address:
  • Phone: 425-243-6922
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number
License Number State

VIII. Authorized Official

Name: DWAN DIAZ
Title or Position: CREDENTIALING COORDINATOR
Credential:
Phone: 425-450-9474