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General NPI Number Information
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NPI Number | 1861654824
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Entity Type | Organization
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Legal Business Name | WASHINGTON PHYSICAL THERAPY
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Dates
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Enumeration Date | 06/30/2008
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Last Update Date | 06/30/2008
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Provider Practice Location Address
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Address Line | 1010 WEST ROBERT BUSH DRIVE
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City | SOUTH BEND
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State | WA
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Zip | 98586
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Country | US
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Telephone | 360-875-5543
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Fax | 360-875-5544
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Provider Business Mailing Address
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Address Line | PO BOX 211
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City | SOUTH BEND
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State | WA
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Zip | 98586-0211
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Country | US
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Telephone | 360-875-5543
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Fax | 360-875-5544
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Authorized Official
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Title or Position | PHYSICAL THERAPIST
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Name | ERNEST D GEIGER
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Credential | PT
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Telephone | 360-875-5543
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2000X
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Taxonomy Name | Physical Therapy Clinic/Center
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License Number | PT00003050
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License Number State | WA
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