Provider Demographics
NPI:1558413716
Name:ALTUS PHYSICAL THERAPY INC
Entity Type:Organization
Organization Name:ALTUS PHYSICAL THERAPY INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT PHYSICAL THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:ERIC
Authorized Official - Middle Name:R
Authorized Official - Last Name:SAKAMOTO
Authorized Official - Suffix:
Authorized Official - Credentials:DPT
Authorized Official - Phone:360-733-0500
Mailing Address - Street 1:PO BOX 31188
Mailing Address - Street 2:
Mailing Address - City:BELLINGHAM
Mailing Address - State:WA
Mailing Address - Zip Code:98228-3188
Mailing Address - Country:US
Mailing Address - Phone:360-733-0500
Mailing Address - Fax:360-671-3366
Practice Address - Street 1:1611 BROADWAY ST
Practice Address - Street 2:
Practice Address - City:BELLINGHAM
Practice Address - State:WA
Practice Address - Zip Code:98225
Practice Address - Country:US
Practice Address - Phone:360-733-0500
Practice Address - Fax:360-671-3366
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-17
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPT00007231225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA87525AOtherREGENCE BCBS
WA183767OtherDEPT OF L & I
WA183767OtherDEPT OF L & I