Provider Demographics
NPI:1558780163
Name:SEATTLE'S ELITE PHYSICAL THERAPY, INC
Entity Type:Organization
Organization Name:SEATTLE'S ELITE PHYSICAL THERAPY, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ASHLEY
Authorized Official - Middle Name:R
Authorized Official - Last Name:SMITH
Authorized Official - Suffix:
Authorized Official - Credentials:DPT
Authorized Official - Phone:206-946-6655
Mailing Address - Street 1:2206 QUEEN ANNE AVE N
Mailing Address - Street 2:SUITE 202
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98109-2370
Mailing Address - Country:US
Mailing Address - Phone:206-946-6655
Mailing Address - Fax:206-946-6656
Practice Address - Street 1:2206 QUEEN ANNE AVE N
Practice Address - Street 2:SUITE 202
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98109-2370
Practice Address - Country:US
Practice Address - Phone:206-946-6655
Practice Address - Fax:206-946-6656
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-04-10
Last Update Date:2016-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA602219412251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedicGroup - Single Specialty