1598982662 NPI number — TMB PARTNERSHIP

Table of content: (NPI 1598982662)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1598982662 NPI number — TMB PARTNERSHIP

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
TMB PARTNERSHIP
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
SOUTH HILL PHYSICAL THERAPY
Provider Other Organization Name Type Code:
3
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1598982662
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
12/13/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
11711 NE 12TH ST STE 3A
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
BELLEVUE
Provider Business Mailing Address State Name:
WA
Provider Business Mailing Address Postal Code:
98005-2461
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
425-450-9474
Provider Business Mailing Address Fax Number:
425-452-0704

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
13909 MERIDIAN E
Provider Second Line Business Practice Location Address:
SUITE A-2
Provider Business Practice Location Address City Name:
PUYALLUP
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
98373-9180
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
253-840-8051
Provider Business Practice Location Address Fax Number:
253-840-4397
Provider Enumeration Date:
04/19/2007

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
COMBS
Authorized Official First Name:
RUTH
Authorized Official Middle Name:
Authorized Official Title or Position:
MANAGER
Authorized Official Telephone Number:
425-450-9474

Provider Taxonomy Codes

  • Taxonomy code: 225100000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 7128184 , issued by the state of ( WA ) . This identifiers is of the category "MEDICAID".