Provider Demographics
NPI:1447209523
Name:PHYSICAL THERAPY CLINICS, INC., PS
Entity Type:Organization
Organization Name:PHYSICAL THERAPY CLINICS, INC., PS
Other - Org Name:WOODINVILLE PHYSICAL THERAPY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:PAIGE
Authorized Official - Middle Name:
Authorized Official - Last Name:SELTZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:425-481-1744
Mailing Address - Street 1:17000 140TH AVE NE
Mailing Address - Street 2:303
Mailing Address - City:WOODINVILLE
Mailing Address - State:WA
Mailing Address - Zip Code:98072-6928
Mailing Address - Country:US
Mailing Address - Phone:425-481-1744
Mailing Address - Fax:425-483-1774
Practice Address - Street 1:17000 140TH AVENUE NE
Practice Address - Street 2:303
Practice Address - City:WOODINVILLE
Practice Address - State:WA
Practice Address - Zip Code:98072-6928
Practice Address - Country:US
Practice Address - Phone:425-481-1744
Practice Address - Fax:425-483-1774
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-08
Last Update Date:2017-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPT000026862251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedicGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA7055171Medicaid
WA7055171Medicaid