Provider Demographics
NPI:1962863274
Name:HOUGHTON PHYSICAL THERAPY LLC
Entity Type:Organization
Organization Name:HOUGHTON PHYSICAL THERAPY LLC
Other - Org Name:LAKE WASHINGTON PHYSICAL THERAPY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:MATTHEW
Authorized Official - Middle Name:
Authorized Official - Last Name:SATO
Authorized Official - Suffix:
Authorized Official - Credentials:DPT
Authorized Official - Phone:206-963-7499
Mailing Address - Street 1:14610 127TH AVE NE
Mailing Address - Street 2:
Mailing Address - City:WOODINVILLE
Mailing Address - State:WA
Mailing Address - Zip Code:98072-4648
Mailing Address - Country:US
Mailing Address - Phone:425-979-7445
Mailing Address - Fax:425-947-8540
Practice Address - Street 1:6710 108TH AVE NE
Practice Address - Street 2:
Practice Address - City:KIRKLAND
Practice Address - State:WA
Practice Address - Zip Code:98033-7050
Practice Address - Country:US
Practice Address - Phone:425-979-7445
Practice Address - Fax:425-947-8540
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-03-14
Last Update Date:2016-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty