Provider Demographics
NPI:1326709163
Name:SEATTLE PEDIATRIC PHYSICAL THERAPY LLC
Entity Type:Organization
Organization Name:SEATTLE PEDIATRIC PHYSICAL THERAPY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICAL THERAPIST
Authorized Official - Prefix:DR
Authorized Official - First Name:PATRICIA
Authorized Official - Middle Name:
Authorized Official - Last Name:GALLANT
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:206-590-2500
Mailing Address - Street 1:2120 1ST AVE N # 109
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98109-2301
Mailing Address - Country:US
Mailing Address - Phone:425-246-1929
Mailing Address - Fax:206-445-7700
Practice Address - Street 1:2120 1ST AVE N # 109
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98109-2301
Practice Address - Country:US
Practice Address - Phone:425-246-1929
Practice Address - Fax:206-445-7700
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-01-04
Last Update Date:2022-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2251P0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistPediatricsGroup - Single Specialty