1497095335 NPI number — A STEP AHEAD PHYSICAL THERAPY LLC

Table of content: SARA VIVIAN BATES M.D. (NPI 1417084864)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1497095335 NPI number — A STEP AHEAD PHYSICAL THERAPY LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
A STEP AHEAD PHYSICAL THERAPY LLC
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:
1497095335
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
05/29/2013
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
4701 S 19TH ST
Provider Second Line Business Mailing Address:
SUITE 100
Provider Business Mailing Address City Name:
TACOMA
Provider Business Mailing Address State Name:
WA
Provider Business Mailing Address Postal Code:
98405-1199
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
253-759-1310
Provider Business Mailing Address Fax Number:
253-759-1330

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
4701 S 19TH ST
Provider Second Line Business Practice Location Address:
SUITE 100
Provider Business Practice Location Address City Name:
TACOMA
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
98405-1199
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
253-759-1310
Provider Business Practice Location Address Fax Number:
253-759-1330
Provider Enumeration Date:
02/28/2013

Additional Information

Authorized Official

Authorized Official Last Name:
RAY
Authorized Official First Name:
SARAH
Authorized Official Middle Name:
K
Authorized Official Title or Position:
OWNER / PHYSICAL THERAPIST
Authorized Official Telephone Number:
253-759-1310

Provider Taxonomy Codes

  • Taxonomy code: 225100000X , with the licence number:  602925885 , 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)





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