Provider Demographics
NPI:1982663498
Name:OLYMPIC PHYSICAL THERAPY OF BELLEVUE INC.
Entity Type:Organization
Organization Name:OLYMPIC PHYSICAL THERAPY OF BELLEVUE INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:LARRY
Authorized Official - Middle Name:
Authorized Official - Last Name:POST
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:425-454-4864
Mailing Address - Street 1:1188 106TH AVE NE
Mailing Address - Street 2:SUITE 100
Mailing Address - City:BELLEVUE
Mailing Address - State:WA
Mailing Address - Zip Code:98004-8614
Mailing Address - Country:US
Mailing Address - Phone:425-455-2630
Mailing Address - Fax:425-451-4390
Practice Address - Street 1:1188 106TH AVE NE
Practice Address - Street 2:SUITE 100
Practice Address - City:BELLEVUE
Practice Address - State:WA
Practice Address - Zip Code:98004-8614
Practice Address - Country:US
Practice Address - Phone:425-455-2630
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-03-22
Last Update Date:2015-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA7047731Medicaid
WA7047731Medicaid