Provider Demographics
NPI:1245831205
Name:SAGE PHYSICAL THERAPY PLLC
Entity type:Organization
Organization Name:SAGE PHYSICAL THERAPY PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:KATHLEEN
Authorized Official - Middle Name:
Authorized Official - Last Name:CAPLES
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:206-972-5978
Mailing Address - Street 1:4701 SW ADMIRAL WAY # 402
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98116-2340
Mailing Address - Country:US
Mailing Address - Phone:206-972-5978
Mailing Address - Fax:206-322-9169
Practice Address - Street 1:1125 E OLIVE ST STE B
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98122-8406
Practice Address - Country:US
Practice Address - Phone:206-972-5978
Practice Address - Fax:206-322-9169
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-11-05
Last Update Date:2020-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedicGroup - Single Specialty