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General NPI Number Information
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NPI Number | 1861660532
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Entity Type | Organization
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Legal Business Name | SEATTLE ORTHOPEDIC & SPORTS PHYSICAL THERAPY, INC.
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Dates
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Enumeration Date | 02/15/2008
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Last Update Date | 03/04/2009
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Provider Practice Location Address
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Address Line | 2924 EASTLAKE AVE E
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City | SEATTLE
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State | WA
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Zip | 98102-3010
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Country | US
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Telephone | 206-729-1405
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Fax | 206-257-0076
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Provider Business Mailing Address
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Address Line | 2427 E MILLER ST
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City | SEATTLE
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State | WA
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Zip | 98112-2201
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Country | US
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Telephone | 206-729-1405
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Fax | 206-257-0076
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Authorized Official
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Title or Position | OWNER DIRECTOR
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Name | JULIE M JOHNSON
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Credential |
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Telephone | 206-729-1405
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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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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