Stacey A Ellingson, PT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

PT00010820 Issued in WA

Practice address

12900 NE 180TH St Ste 110
Bothell, WA 98011-5773

Phone

(425) 483-4270

Fax

(425) 483-4268

NPI assigned

Jan 7, 2008

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Stacey A Schwenk Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Physiotherapy Associates, Inc

  dba Select Physical Therapy

  • Physical Therapy Clinic/Center
  • Olympia, WA
  • NPI 1689319154
  NPD (past)

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

{
    "created_epoch": "1199664000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1522800000000",
    "number": "1104001452",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2170",
            "city": "SUMNER",
            "state": "WA",
            "postal_code": "983900480",
            "telephone_number": "253-840-2313",
            "fax_number": "253-840-6340"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12900 NE 180TH ST STE 110",
            "city": "BOTHELL",
            "state": "WA",
            "postal_code": "980115773",
            "telephone_number": "425-483-4270",
            "fax_number": "425-483-4268"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "19119 N Creek Pkwy Ste 107",
            "address_purpose": "LOCATION",
            "city": "Bothell",
            "state": "WA",
            "postal_code": "980118023",
            "country_code": "US",
            "telephone_number": "425-486-8800",
            "fax_number": "425-485-8848",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ELLINGSON",
        "first_name": "STACEY",
        "middle_name": "A",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-01-07",
        "last_updated": "2018-04-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "WA",
            "license": "PT00010820",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "STACEY",
            "last_name": "SCHWENK",
            "middle_name": "A",
            "credential": "PT",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Anita Elangovan, MD
• Sudha Elangovan, M.D.
• Jennifer L Elf, MS
• Elim Consultants, LLC. (Epc)
• Elim Pharmaceutical Consultants, LLC.
• Sara Ann Ellinwood
• Jill Elliott, OTR/L
• Kelsie Kay Ellis, L.M.T.
• Kimberly S Ellis, P.T.
• Rebecca Ellsworth

• Physical Therapist in Bothell, WA
• Providers in Bothell, WA by specialty
• Physical Therapist in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 4, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.