| Organization Name: | EVERETT PHYSICAL THERAPY AND SPORTS PERFORMANCE CENTER LLC |
| NPI Number: | 1003272675 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | MICHAEL SHANNON OKELLLEY (OWNER/PRESIDENT) |
| Mailing Address: | 10600 Ne 68th St Suite C Kirkland |
| State: | WA US |
| Postal Code: | 980337044 |
| Phone Number: | 4258231389 |
| Fax Number: | 4258203996 |
| NPI Enumeration Date: | 01/12/2016 |
| NPI Last Update Date: | 01/12/2016 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 225100000X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | WA |
| Taxonomy Type: | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Taxonomy Classification: | Physical Therapist |
| Taxonomy Specialization: | |
| Taxonomy Definition: | (1) Physical therapists are health care professionals who evaluate and treat people with health problems resulting from injury or disease. PT |