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NPI Code Detail

MEDICARE: ADAM CHARLES SHILDMYER DPT

MEDICARE: ADAM CHARLES SHILDMYER DPT
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 TherapistPT 60285896WA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1144579681
Entity Type Code : Individual
Provider Name (Legal Business Name) : ADAM CHARLES SHILDMYER DPT
Provider Business Mailing Address
First Line : PO BOX 50095
Second Line :
City : SEATTLE
State : WA
Zip : 98145-5095
Country : US
Telephone Number : 206-520-5700
Fax Number :
Provider Business Practice Location Address
First Line : 1455 NW LEARY WAY STE 150
Second Line :
City : SEATTLE
State : WA
Zip : 98107-5140
Country : US
Telephone Number : 206-520-5000
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/30/2012
Last Update Date : 11/12/2019

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Directions to “ ADAM CHARLES SHILDMYER DPT” Practice Location

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