=====================================================
General NPI Number Information
=====================================================
NPI Number | 1215260823
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | ERIN SACHI CHADBURN P.T.
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 09/14/2009
-----------------------------------------------------
Last Update Date | 07/21/2022
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 727 ERICKSEN AVE NE STE 210
-----------------------------------------------------
City | BAINBRIDGE ISLAND
-----------------------------------------------------
State | WA
-----------------------------------------------------
Zip | 98110-1882
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 206-319-1546
-----------------------------------------------------
Fax | 855-859-1546
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 123 BJUNE DR SE STE 111
-----------------------------------------------------
City | BAINBRIDGE ISLAND
-----------------------------------------------------
State | WA
-----------------------------------------------------
Zip | 98110-2459
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 206-319-1546
-----------------------------------------------------
Fax | 206-842-5206
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 225100000X
-----------------------------------------------------
Taxonomy Name | Physical Therapist
-----------------------------------------------------
License Number | PT60103919
-----------------------------------------------------
License Number State | WA
-----------------------------------------------------