Organization Name: | MOUNTLAKE SPORTS & PHYSICAL THERAPY PS |
NPI Number: | 1528331402 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | JAMIE MALIJAN (CLINICAL MANAGER) |
Mailing Address: | 9505 19th Ave Se 101 Everett |
State: | WA US |
Postal Code: | 982083853 |
Phone Number: | 4253798120 |
Fax Number: | 4253381789 |
NPI Enumeration Date: | 02/22/2012 |
NPI Last Update Date: | 02/22/2012 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 225100000X |
License Number: | PT60178380 |
Healthcare Provider Taxonomy: (Secondary) | N |
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 |