Provider Demographics
NPI:1750703567
Name:STRIDE PHYSIO PLLC
Entity type:Organization
Organization Name:STRIDE PHYSIO PLLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:SUSANNE
Authorized Official - Middle Name:FT
Authorized Official - Last Name:MICHAUD
Authorized Official - Suffix:
Authorized Official - Credentials:DPT
Authorized Official - Phone:206-547-7445
Mailing Address - Street 1:9046 PHINNEY AVE N
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98103-3719
Mailing Address - Country:US
Mailing Address - Phone:206-547-7445
Mailing Address - Fax:206-297-6080
Practice Address - Street 1:100 NE NORTHLAKE WAY
Practice Address - Street 2:SUITE 200B
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98105-6869
Practice Address - Country:US
Practice Address - Phone:206-547-7445
Practice Address - Fax:206-913-2486
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-01-13
Last Update Date:2014-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPT00010710261QP2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy