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General NPI Number Information
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NPI Number | 1922972900
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Entity Type | Organization
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Legal Business Name | CORE FOUNDATIONS PHYSICAL THERAPY LLC
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Dates
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Enumeration Date | 10/02/2025
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Last Update Date | 10/02/2025
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Provider Practice Location Address
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Address Line | 109 S 65TH AVE STE 105
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City | RIDGEFIELD
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State | WA
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Zip | 98642-3408
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Country | US
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Telephone | 425-241-0172
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Fax | 253-650-6458
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Provider Business Mailing Address
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Address Line | 1763 S 18TH CIR
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City | RIDGEFIELD
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State | WA
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Zip | 98642-7815
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Country | US
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Telephone | 425-241-0172
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Fax | 253-650-6458
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Authorized Official
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Title or Position | OWNER/PT
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Name | MS. MEGHAN PECK
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Credential | DPT
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Telephone | 425-241-0172
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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 |
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License Number State |
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