1457397531 NPI number — COLUMBIA PHYSICAL THERAPY INC PS

Table of content: (NPI 1457397531)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1457397531 NPI number — COLUMBIA PHYSICAL THERAPY INC PS

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
COLUMBIA PHYSICAL THERAPY INC PS
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:
Provider Other Organization Name Type Code:
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:
1457397531
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
12/19/2013
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
7201 W CLEARWATER AVE STE B101
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
KENNEWICK
Provider Business Mailing Address State Name:
WA
Provider Business Mailing Address Postal Code:
99336-1694
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
509-544-0265
Provider Business Mailing Address Fax Number:
509-987-1614

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
7201 W CLEARWATER AVE STE B101
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
KENNEWICK
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
99336-1694
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
509-544-0265
Provider Business Practice Location Address Fax Number:
509-987-1614
Provider Enumeration Date:
06/20/2006

Additional Information

Authorized Official

Authorized Official Last Name:
HEATH
Authorized Official First Name:
CLARK
Authorized Official Middle Name:
Authorized Official Title or Position:
BOARD OF DIRECTORS
Authorized Official Telephone Number:
509-544-0265

Provider Taxonomy Codes

  • Taxonomy code: 225100000X , with the licence number:  PT00007870 , registered in the state of WA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 225100000X , with the licence number: PT00009869 , registered in the state of WA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 225100000X , with the licence number: PT00008684 , registered in the state of WA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 225100000X , with the licence number: PT00006293 , registered in the state of WA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 225100000X , with the licence number: PT00006195 , registered in the state of WA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 225100000X , with the licence number: PT00007653 , registered in the state of WA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 225100000X , with the licence number: 4284 , registered in the state of OR ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 225100000X , with the licence number: 4566 , registered in the state of OR ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 225100000X , with the licence number: PT00009468 , registered in the state of WA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 225100000X , with the licence number: PT00006264 , registered in the state of WA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 225100000X , with the licence number: PT00006198 , registered in the state of WA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 225100000X , with the licence number: PT00008040 , registered in the state of WA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 225100000X , with the licence number: PT00009184 , registered in the state of WA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 225100000X , with the licence number: 4916 , registered in the state of OR ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 225100000X , with the licence number: PT00007804 , registered in the state of WA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 7047525 , issued by the state of ( WA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 7091325 , issued by the state of ( WA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 7089956 , issued by the state of ( WA ) . This identifiers is of the category "MEDICAID".




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