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NPI Code Detail

MEDICARE: KAIZEN PHYSICAL THERAPY, PLLC

MEDICARE: KAIZEN PHYSICAL THERAPY, PLLC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1225100000XPhysical Therapist

General Provider Information

NPI Number : 1083195820
Entity Type Code : Organization
Provider Name (Legal Business Name) : KAIZEN PHYSICAL THERAPY, PLLC
Provider Business Mailing Address
First Line : 5808 123RD PL SE
Second Line :
City : SNOHOMISH
State : WA
Zip : 98296-8900
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 5025 25TH AVE NE STE 201
Second Line :
City : SEATTLE
State : WA
Zip : 98105-4152
Country : US
Telephone Number : 206-524-6702
Fax Number :
Authorized Official
Title or Position : OWNER, PHYSICAL THERAPIST
Name : DR. COLIN MARTIN SISCO
Credential : DPT, OCS
Telephone Number : 206-524-6702
Provider Enumeration Date : 08/28/2018
Last Update Date : 01/20/2024

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