Provider Demographics
NPI:1972824316
Name:POWERS PHYSICAL THERAPY, PLLC
Entity Type:Organization
Organization Name:POWERS PHYSICAL THERAPY, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MARGARET
Authorized Official - Middle Name:SUSAN
Authorized Official - Last Name:POWERS
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:206-755-3112
Mailing Address - Street 1:330 MADISON AVE S
Mailing Address - Street 2:SUITE 106
Mailing Address - City:BAINBRIDGE ISLAND
Mailing Address - State:WA
Mailing Address - Zip Code:98110-2544
Mailing Address - Country:US
Mailing Address - Phone:206-755-3112
Mailing Address - Fax:
Practice Address - Street 1:330 MADISON AVE S
Practice Address - Street 2:SUITE 106
Practice Address - City:BAINBRIDGE ISLAND
Practice Address - State:WA
Practice Address - Zip Code:98110-2544
Practice Address - Country:US
Practice Address - Phone:206-755-3112
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-06-21
Last Update Date:2010-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPT00003730261QP2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy