Provider Demographics
NPI:1467056432
Name:ENGINEERED SPORTS 2 PLLC
Entity Type:Organization
Organization Name:ENGINEERED SPORTS 2 PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:
Authorized Official - Last Name:HAMRE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:425-220-1531
Mailing Address - Street 1:2205 WALL ST
Mailing Address - Street 2:
Mailing Address - City:EVERETT
Mailing Address - State:WA
Mailing Address - Zip Code:98201-3761
Mailing Address - Country:US
Mailing Address - Phone:425-512-8695
Mailing Address - Fax:425-512-8697
Practice Address - Street 1:4020 136TH ST NE STE 102-104
Practice Address - Street 2:
Practice Address - City:MARYSVILLE
Practice Address - State:WA
Practice Address - Zip Code:98271-7817
Practice Address - Country:US
Practice Address - Phone:425-512-8695
Practice Address - Fax:425-512-8697
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-11-30
Last Update Date:2020-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty