Provider Demographics
NPI:1568669406
Name:CORE PHYSICAL THERAPY PC
Entity Type:Organization
Organization Name:CORE PHYSICAL THERAPY PC
Other - Org Name:BELLTOWN PHYSICAL THERAPY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:PAUL
Authorized Official - Middle Name:
Authorized Official - Last Name:DE BEIJL
Authorized Official - Suffix:
Authorized Official - Credentials:PT, LAC
Authorized Official - Phone:206-623-2220
Mailing Address - Street 1:720 OLIVE WAY STE 900
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98101-1840
Mailing Address - Country:US
Mailing Address - Phone:206-623-2220
Mailing Address - Fax:206-623-2228
Practice Address - Street 1:2505 2ND AVE STE 100
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98121-1464
Practice Address - Country:US
Practice Address - Phone:206-624-4020
Practice Address - Fax:206-443-3999
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-07-02
Last Update Date:2022-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA7101066Medicaid
WA144285OtherL&I
WAG8801833Medicare UPIN