Individual provider Active NPI

Wendolyn Anne Rue, PT

  • Physical Therapist
  • Oak Harbor, WA
National Provider Identifier
1003947854
Registry record updated Feb 21, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
00006648 Issued in WA
Practice address
5197 Anglers Haven Dr
Oak Harbor, WA 98277-9607
Phone
(360) 421-2852
NPI assigned
Mar 7, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 21, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X PT00006648 WA
Physical Therapist 225100000X 00006648 WA Primary

Addresses

Primary practice location

5197 Anglers Haven Dr
Oak Harbor, WA 98277-9607

Mailing address

785 SE Bayshore Dr. Suite 102
Oak Harbor, WA 98277-4062
Phone (360) 279-8323

Other identifiers 1

IdentifierTypeStateIssuer
0189569OtherWALABOR AND INDUSTRIES

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050413001337 WA Practitioner - Physical Therapist in Private Practice 5193762029

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PT00006648WAMDSpecialist
00006648WAMDPhysical Therapist

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1173225600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1740096000000",
    "number": "1003947854",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "785 SE BAYSHORE DR. SUITE 102",
            "city": "OAK HARBOR",
            "state": "WA",
            "postal_code": "982774062",
            "telephone_number": "360-279-8323",
            "fax_number": "360-279-8772"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5197 ANGLERS HAVEN DR",
            "city": "OAK HARBOR",
            "state": "WA",
            "postal_code": "982779607",
            "telephone_number": "360-421-2852"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUE",
        "first_name": "WENDOLYN",
        "middle_name": "ANNE",
        "name_prefix": "Ms.",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-07",
        "last_updated": "2025-02-21",
        "certification_date": "2025-02-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "WA",
            "license": "PT00006648",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "WA",
            "license": "00006648",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LABOR AND INDUSTRIES",
            "identifier": "0189569",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Oak Harbor, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 21, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.