Provider Demographics
NPI:1437394715
Name:BRITEVALE PHYSICAL THERAPY
Entity Type:Organization
Organization Name:BRITEVALE PHYSICAL THERAPY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PT
Authorized Official - Prefix:
Authorized Official - First Name:SONJA
Authorized Official - Middle Name:KATHLEEN
Authorized Official - Last Name:THORNTON
Authorized Official - Suffix:
Authorized Official - Credentials:BSCR PT, OT
Authorized Official - Phone:509-476-3373
Mailing Address - Street 1:125 ONEIL RD
Mailing Address - Street 2:
Mailing Address - City:OROVILLE
Mailing Address - State:WA
Mailing Address - Zip Code:98844-9780
Mailing Address - Country:US
Mailing Address - Phone:509-476-3373
Mailing Address - Fax:
Practice Address - Street 1:1300 MAIN ST
Practice Address - Street 2:
Practice Address - City:OROVILLE
Practice Address - State:WA
Practice Address - Zip Code:98844-9384
Practice Address - Country:US
Practice Address - Phone:509-476-2020
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-12-15
Last Update Date:2008-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPT00003755261QP2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy