Provider Demographics
NPI:1497944540
Name:QUALITY PHYSICAL THERAPY, INC. P.S.
Entity Type:Organization
Organization Name:QUALITY PHYSICAL THERAPY, INC. P.S.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ANN
Authorized Official - Middle Name:LARSON
Authorized Official - Last Name:SPINK
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:360-757-9335
Mailing Address - Street 1:120 E GEORGE HOPPER RD
Mailing Address - Street 2:SUITE 220
Mailing Address - City:BURLINGTON
Mailing Address - State:WA
Mailing Address - Zip Code:98233-3125
Mailing Address - Country:US
Mailing Address - Phone:360-757-9335
Mailing Address - Fax:360-757-9886
Practice Address - Street 1:1838 S BURLINGTON BLVD
Practice Address - Street 2:
Practice Address - City:BURLINGTON
Practice Address - State:WA
Practice Address - Zip Code:98233
Practice Address - Country:US
Practice Address - Phone:360-757-9335
Practice Address - Fax:360-757-9886
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-15
Last Update Date:2018-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA602177381261QP2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA3592QUOtherREGENCE
WA650017406OtherRAILROAD MEDICARE
WA0157496OtherL&I
WA3592QUOtherREGENCE