Provider Demographics
NPI:1649728551
Name:THE PARKINSON'S FITNESS PROJECT PLLC
Entity type:Organization
Organization Name:THE PARKINSON'S FITNESS PROJECT PLLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:NATHAN
Authorized Official - Middle Name:ALLEN
Authorized Official - Last Name:COOMER
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:304-506-3876
Mailing Address - Street 1:3808 E SUPERIOR ST
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98122-6566
Mailing Address - Country:US
Mailing Address - Phone:304-506-3876
Mailing Address - Fax:120-626-0360
Practice Address - Street 1:106 LAKESIDE AVE
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98122-6542
Practice Address - Country:US
Practice Address - Phone:206-860-5172
Practice Address - Fax:120-626-0360
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-09-20
Last Update Date:2017-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA602773442251N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2251N0400XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistNeurologyGroup - Single Specialty