Provider Demographics
NPI:1003319088
Name:ALPINE PHYSICAL THERAPY PLLC
Entity Type:Organization
Organization Name:ALPINE PHYSICAL THERAPY PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ELI
Authorized Official - Middle Name:
Authorized Official - Last Name:ZYGMUNOTICZ
Authorized Official - Suffix:
Authorized Official - Credentials:DPT
Authorized Official - Phone:206-284-2396
Mailing Address - Street 1:3800 WOODLAND PARK AVE N STE 100
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98103-7943
Mailing Address - Country:US
Mailing Address - Phone:206-284-2396
Mailing Address - Fax:206-547-9286
Practice Address - Street 1:109 SE 101ST AVE
Practice Address - Street 2:
Practice Address - City:VANCOUVER
Practice Address - State:WA
Practice Address - Zip Code:98664-3907
Practice Address - Country:US
Practice Address - Phone:206-284-2396
Practice Address - Fax:206-547-9286
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-03-15
Last Update Date:2018-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy