Provider Demographics
NPI:1407036528
Name:ACTION PHYSICAL THERAPY, INC
Entity Type:Organization
Organization Name:ACTION PHYSICAL THERAPY, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MICHEL
Authorized Official - Middle Name:LYNN
Authorized Official - Last Name:HANSON
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:360-738-7550
Mailing Address - Street 1:PO BOX 29587
Mailing Address - Street 2:
Mailing Address - City:BELLINGHAM
Mailing Address - State:WA
Mailing Address - Zip Code:98228-1587
Mailing Address - Country:US
Mailing Address - Phone:360-738-7550
Mailing Address - Fax:360-738-7870
Practice Address - Street 1:1504 IOWA ST
Practice Address - Street 2:A
Practice Address - City:BELLINGHAM
Practice Address - State:WA
Practice Address - Zip Code:98229-4709
Practice Address - Country:US
Practice Address - Phone:360-738-7550
Practice Address - Fax:360-738-7870
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-11-06
Last Update Date:2008-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA261QP2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA5489HAOtherREGENCE
WA0179435OtherDEPT OF L & I