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NPI Code Detail

MEDICARE: MRS. SARAH ELAINE MATTSON PT DPT OCS

MEDICARE: MRS. SARAH ELAINE MATTSON PT DPT OCS
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 TherapistPT1998ID
2225100000XPhysical TherapistPT00009833WA
3225100000XPhysical Therapist034086NY

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 : 1952342396
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. SARAH ELAINE MATTSON PT DPT OCS
Provider Business Mailing Address
First Line : 240 W FRONT ST
Second Line :
City : PORT ANGELES
State : WA
Zip : 98362-2609
Country : US
Telephone Number : 360-565-0700
Fax Number :
Provider Business Practice Location Address
First Line : 240 W FRONT ST
Second Line :
City : PORT ANGELES
State : WA
Zip : 98362-2609
Country : US
Telephone Number : 360-565-0700
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/09/2006
Last Update Date : 12/20/2013

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