Provider Demographics
NPI: | 1700516606 |
---|---|
Name: | VESTIBULAR THERAPY SPECIALISTS, PLLC |
Entity Type: | Organization |
Organization Name: | VESTIBULAR THERAPY SPECIALISTS, PLLC |
Other - Org Name: | VESTIBULAR THERAPY SPECIALISTS |
Other - Org Type: | Doing Business As |
Authorized Official - Title/Position: | OWNER |
Authorized Official - Prefix: | |
Authorized Official - First Name: | KAELA |
Authorized Official - Middle Name: | |
Authorized Official - Last Name: | PAULY |
Authorized Official - Suffix: | |
Authorized Official - Credentials: | DPT |
Authorized Official - Phone: | 206-672-0145 |
Mailing Address - Street 1: | 10564 5TH AVE NE STE 405 |
Mailing Address - Street 2: | |
Mailing Address - City: | SEATTLE |
Mailing Address - State: | WA |
Mailing Address - Zip Code: | 98125-7200 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 206-672-0145 |
Mailing Address - Fax: | 855-564-1831 |
Practice Address - Street 1: | 10564 5TH AVE NE STE 405 |
Practice Address - Street 2: | |
Practice Address - City: | SEATTLE |
Practice Address - State: | WA |
Practice Address - Zip Code: | 98125-7200 |
Practice Address - Country: | US |
Practice Address - Phone: | 206-672-0145 |
Practice Address - Fax: | 855-564-1831 |
EIN: | <UNAVAIL> |
Is Organization Subpart?: | No |
Parent Organization LBN: | |
Parent Organization TIN: | |
Enumeration Date: | 2022-06-14 |
Last Update Date: | 2023-10-25 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization |
---|---|---|---|---|
Yes | 261QP2000X | Ambulatory Health Care Facilities | Clinic/Center | Physical Therapy |