MEDICARE: CARRIE ON PHYSICAL THERAPY PLLC

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy
1	224Z00000X	Occupational Therapy Assistant
2	225200000X	Physical Therapy Assistant
3	225X00000X	Occupational Therapist
4	235Z00000X	Speech-Language Pathologist
5	225100000X	Physical Therapist

General Provider Information

NPI Number	:	1841759396
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CARRIE ON PHYSICAL THERAPY PLLC

Provider Business Mailing Address
First Line	:	6632 SW LUANA BEACH RD
Second Line	:
City	:	VASHON
State	:	WA
Zip	:	98070-7222
Country	:	US
Telephone Number	:	206-459-7724
Fax Number	:	833-812-3397

Provider Business Practice Location Address
First Line	:	6632 SW LUANA BEACH RD
Second Line	:
City	:	VASHON
State	:	WA
Zip	:	98070-7222
Country	:	US
Telephone Number	:	206-459-7724
Fax Number	:	833-812-3397

Authorized Official
Title or Position	:	OWNER/PT PROVIDER
Name	:	CARRIE A CHAMBERS
Credential	:	MPT
Telephone Number	:	206-459-7724

Provider Enumeration Date	:	03/14/2019
Last Update Date	:	09/06/2023

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