Provider Demographics
NPI:1679138945
Name:MOBILITY COACHING AND OUTFITTING, PLLC
Entity Type:Organization
Organization Name:MOBILITY COACHING AND OUTFITTING, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT AND CO-OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ELISA
Authorized Official - Middle Name:CHRISTINE
Authorized Official - Last Name:SMITH
Authorized Official - Suffix:
Authorized Official - Credentials:PT, DPT, NCS
Authorized Official - Phone:206-419-7793
Mailing Address - Street 1:1301 N 184TH CT
Mailing Address - Street 2:
Mailing Address - City:SHORELINE
Mailing Address - State:WA
Mailing Address - Zip Code:98133-4538
Mailing Address - Country:US
Mailing Address - Phone:206-419-7793
Mailing Address - Fax:
Practice Address - Street 1:1301 N 184TH CT
Practice Address - Street 2:
Practice Address - City:SHORELINE
Practice Address - State:WA
Practice Address - Zip Code:98133-4538
Practice Address - Country:US
Practice Address - Phone:206-419-7793
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-05-02
Last Update Date:2019-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty