Provider Demographics
NPI:1861660532
Name:SEATTLE ORTHOPEDIC & SPORTS PHYSICAL THERAPY, INC.
Entity Type:Organization
Organization Name:SEATTLE ORTHOPEDIC & SPORTS PHYSICAL THERAPY, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:JULIE
Authorized Official - Middle Name:M
Authorized Official - Last Name:JOHNSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:206-729-1405
Mailing Address - Street 1:2427 E MILLER ST
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98112-2201
Mailing Address - Country:US
Mailing Address - Phone:206-729-1405
Mailing Address - Fax:206-257-0076
Practice Address - Street 1:2924 EASTLAKE AVE E
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98102-3010
Practice Address - Country:US
Practice Address - Phone:206-729-1405
Practice Address - Fax:206-257-0076
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-02-15
Last Update Date:2009-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty