Provider Demographics
NPI:1750400321
Name:SOBIE, TIMOTHY J (PT, PHD)
Entity type:Individual
Prefix:MR
First Name:TIMOTHY
Middle Name:J
Last Name:SOBIE
Suffix:
Gender:M
Credentials:PT, PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:201 N I ST
Mailing Address - Street 2:
Mailing Address - City:TACOMA
Mailing Address - State:WA
Mailing Address - Zip Code:98403-1925
Mailing Address - Country:US
Mailing Address - Phone:253-572-4611
Mailing Address - Fax:253-572-4643
Practice Address - Street 1:201 N I ST
Practice Address - Street 2:
Practice Address - City:TACOMA
Practice Address - State:WA
Practice Address - Zip Code:98403-1925
Practice Address - Country:US
Practice Address - Phone:253-572-4611
Practice Address - Fax:253-572-4643
Is Sole Proprietor?:No
Enumeration Date:2007-03-28
Last Update Date:2020-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPT00003867225100000X, 225100000X, 2251N0400X
ORFELDENKRAISCERT 1528174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
No174400000XOther Service ProvidersSpecialist
No2251N0400XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistNeurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA7081334Medicaid
WA650021362OtherRAIL ROAD MEDICARE