MEDICARE: VANTAGE PHYSICAL THERAPY

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
1	261QP2000X	Physical Therapy Clinic/Center

General Provider Information

NPI Number	:	1255949178
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	VANTAGE PHYSICAL THERAPY

Provider Business Mailing Address
First Line	:	2710 S KING ST
Second Line	:
City	:	SEATTLE
State	:	WA
Zip	:	98144-2446
Country	:	US
Telephone Number	:	206-659-6395
Fax Number	:

Provider Business Practice Location Address
First Line	:	2710 S KING ST
Second Line	:
City	:	SEATTLE
State	:	WA
Zip	:	98144-2446
Country	:	US
Telephone Number	:	206-659-6395
Fax Number	:

Authorized Official
Title or Position	:	PHYSICAL THERAPIST/OWNER
Name	:	BRIAN CROSIER
Credential	:	PT
Telephone Number	:	206-659-6359

Provider Enumeration Date	:	07/16/2020
Last Update Date	:	07/16/2020

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Directions to “VANTAGE PHYSICAL THERAPY ” Practice Location

Language	Start Address	Practice Location

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