Provider Demographics
NPI:1437291176
Name:SAMPSON ENTERPRISES INC
Entity Type:Organization
Organization Name:SAMPSON ENTERPRISES INC
Other - Org Name:BODYLINK
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:GREGG
Authorized Official - Middle Name:O
Authorized Official - Last Name:SAMPSON
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:360-337-7662
Mailing Address - Street 1:9621 RIDGETOP BLVD NW
Mailing Address - Street 2:SUITE 100
Mailing Address - City:SILVERDALE
Mailing Address - State:WA
Mailing Address - Zip Code:98383-8502
Mailing Address - Country:US
Mailing Address - Phone:360-337-7662
Mailing Address - Fax:360-337-7300
Practice Address - Street 1:9621 RIDGETOP BLVD NW
Practice Address - Street 2:SUITE 100
Practice Address - City:SILVERDALE
Practice Address - State:WA
Practice Address - Zip Code:98383-8502
Practice Address - Country:US
Practice Address - Phone:360-337-7662
Practice Address - Fax:360-337-7300
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-12
Last Update Date:2020-08-22
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
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA7108327Medicaid
WA0153006OtherL&I GROUP NUMBER
WA7108327Medicaid