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General NPI Number Information
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NPI Number | 1285452789
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Entity Type | Organization
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Legal Business Name | ADELINE PHYSICAL THERAPY PLLC
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Dates
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Enumeration Date | 10/02/2024
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Last Update Date | 10/02/2024
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Provider Practice Location Address
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Address Line | 1429 20TH AVE SW
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City | PUYALLUP
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State | WA
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Zip | 98371-7301
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Country | US
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Telephone | 253-256-5505
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Fax |
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Provider Business Mailing Address
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Address Line | 1429 20TH AVE SW
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City | PUYALLUP
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State | WA
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Zip | 98371-7301
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Country | US
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Telephone | 253-256-5505
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | COLIN KENDALL MCDANNEL
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Credential | PT, DPT
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Telephone | 253-256-5505
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2251S0007X
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Taxonomy Name | Sports Physical Therapist
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 2251G0304X
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Taxonomy Name | Geriatric Physical Therapist
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 2251E1200X
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Taxonomy Name | Ergonomics Physical Therapist
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 2251H1300X
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Taxonomy Name | Human Factors Physical Therapist
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License Number |
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License Number State |
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