Provider Demographics
NPI:1245011196
Name:TRILLIUM PHYSICAL THERAPY
Entity type:Organization
Organization Name:TRILLIUM PHYSICAL THERAPY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ANNA
Authorized Official - Middle Name:KATHLEEN
Authorized Official - Last Name:SMITH
Authorized Official - Suffix:
Authorized Official - Credentials:DPT
Authorized Official - Phone:253-831-5670
Mailing Address - Street 1:3031 ORLEANS ST STE 101
Mailing Address - Street 2:
Mailing Address - City:BELLINGHAM
Mailing Address - State:WA
Mailing Address - Zip Code:98226-3557
Mailing Address - Country:US
Mailing Address - Phone:360-230-8553
Mailing Address - Fax:360-359-7706
Practice Address - Street 1:3031 ORLEANS ST STE 101
Practice Address - Street 2:
Practice Address - City:BELLINGHAM
Practice Address - State:WA
Practice Address - Zip Code:98226-3557
Practice Address - Country:US
Practice Address - Phone:360-230-8553
Practice Address - Fax:360-359-7706
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-10-06
Last Update Date:2023-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy