Provider Demographics
NPI:1235762832
Name:ACCESSIBLE LIVING PHYSICAL THERAPY
Entity Type:Organization
Organization Name:ACCESSIBLE LIVING PHYSICAL THERAPY
Other - Org Name:ACCESSIBLE LIVING PT
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:GABRIEL
Authorized Official - Middle Name:
Authorized Official - Last Name:GIRAUD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:360-259-2445
Mailing Address - Street 1:1910 EAST 4TH AVE
Mailing Address - Street 2:PMB 121
Mailing Address - City:OLYMPIA
Mailing Address - State:WA
Mailing Address - Zip Code:98506
Mailing Address - Country:US
Mailing Address - Phone:360-259-2445
Mailing Address - Fax:
Practice Address - Street 1:2212 DUBLIN DRIVE NW
Practice Address - Street 2:
Practice Address - City:OLYMPIA
Practice Address - State:WA
Practice Address - Zip Code:98502
Practice Address - Country:US
Practice Address - Phone:360-259-2445
Practice Address - Fax:360-252-8349
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-02-21
Last Update Date:2023-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy
No225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty