Provider Demographics
NPI:1003986233
Name:CORE PERFORMANCE LLC
Entity Type:Organization
Organization Name:CORE PERFORMANCE LLC
Other - Org Name:COREPHYSIO
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/CEO
Authorized Official - Prefix:MRS
Authorized Official - First Name:ELIZABETH
Authorized Official - Middle Name:MARSH
Authorized Official - Last Name:HAMPTON
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:360-752-2673
Mailing Address - Street 1:1514 12TH STREET
Mailing Address - Street 2:SUITE #103
Mailing Address - City:BELLINGHAM
Mailing Address - State:WA
Mailing Address - Zip Code:98225
Mailing Address - Country:US
Mailing Address - Phone:360-752-2673
Mailing Address - Fax:360-752-0271
Practice Address - Street 1:1514 12TH STREET
Practice Address - Street 2:SUITE #103
Practice Address - City:BELLINGHAM
Practice Address - State:WA
Practice Address - Zip Code:98225
Practice Address - Country:US
Practice Address - Phone:360-752-2673
Practice Address - Fax:360-752-0271
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-08
Last Update Date:2014-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty