| Organization Name: | PHENIX PHYSICAL THERAPY & PERSONAL WELLNESS, LLC |
| NPI Number: | 1538550926 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | REID M KUETHER (CEO/PHYSICAL THERAPIST) |
| Mailing Address: | 1301 4th Ave Nw Suite 300 Issaquah |
| State: | WA US |
| Postal Code: | 980279371 |
| Phone Number: | 4253957317 |
| Fax Number: | 4253957319 |
| NPI Enumeration Date: | 02/06/2015 |
| NPI Last Update Date: | 08/18/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 225700000X |
| License Number: | MA00012293 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | WA |
| Taxonomy Type: | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Taxonomy Classification: | Massage Therapist |
| Taxonomy Specialization: | |
| Taxonomy Definition: | An individual trained in the manipulation of tissues (as by rubbing, stroking, kneading, or tapping) with the hand or an instrument for remedial or hygienic purposes. |