Provider Demographics
NPI:1710285531
Name:CASCADIA PHYSICAL THERAPY
Entity Type:Organization
Organization Name:CASCADIA PHYSICAL THERAPY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER, PHYSICAL THERAPIST
Authorized Official - Prefix:MR
Authorized Official - First Name:AVILIO
Authorized Official - Middle Name:T
Authorized Official - Last Name:HALME
Authorized Official - Suffix:
Authorized Official - Credentials:MPT
Authorized Official - Phone:360-734-0222
Mailing Address - Street 1:910 HARRIS AVE
Mailing Address - Street 2:STE.101
Mailing Address - City:BELLINGHAM
Mailing Address - State:WA
Mailing Address - Zip Code:98225-7008
Mailing Address - Country:US
Mailing Address - Phone:360-734-0222
Mailing Address - Fax:360-734-2990
Practice Address - Street 1:910 HARRIS AVE
Practice Address - Street 2:STE.101
Practice Address - City:BELLINGHAM
Practice Address - State:WA
Practice Address - Zip Code:98225-7008
Practice Address - Country:US
Practice Address - Phone:360-734-0222
Practice Address - Fax:360-734-2990
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-03-02
Last Update Date:2011-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPT000077002251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedicGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA7134950Medicaid
WA7134950Medicaid