Provider Demographics
NPI:1275686297
Name:WAVE THERAPIES PLLC
Entity Type:Organization
Organization Name:WAVE THERAPIES PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER-THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:JENNIFER
Authorized Official - Middle Name:
Authorized Official - Last Name:MARTYN
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:206-782-5555
Mailing Address - Street 1:PO BOX 3432
Mailing Address - Street 2:
Mailing Address - City:REDMOND
Mailing Address - State:WA
Mailing Address - Zip Code:98073-3432
Mailing Address - Country:US
Mailing Address - Phone:206-782-5555
Mailing Address - Fax:425-868-9922
Practice Address - Street 1:7711 196TH AVE NE
Practice Address - Street 2:
Practice Address - City:REDMOND
Practice Address - State:WA
Practice Address - Zip Code:98053-4700
Practice Address - Country:US
Practice Address - Phone:206-782-5555
Practice Address - Fax:425-868-9922
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-21
Last Update Date:2008-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty