Samantha Iranon, DPT
Individual provider Active NPI Physical Therapist · Deer Park, WA
NPI 1104201573 · NPPES record last updated Jun 16, 2016
Key facts
- NPI
- 1104201573
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physical Therapist 225100000X
- License
- 60539729 (WA)
- Practice address
- 707 S Park St
Deer Park, WA 99006-7025 - Phone
- (509) 276-8811
- NPI assigned
- Jul 27, 2015
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 2
Medicare Care Compare profile
- Specialty
- Physical Therapist in Private Practice
- Education
- Other, 2015
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- U District Physical Therapy and Institute of Sports Performance
Practice addresses (Care Compare)
730 N Hamilton St
Spokane, WA 99202-2045
Phone (509) 458-7686
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in WA
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20160803003191 | WA | Practitioner - Physical Therapist in Private Practice | 4486948155 | Reassigns benefits to 2 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 60539729 | WA | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Deer Park Physical Therapy Inc | Physical Therapist | Current |
Accepting new patients |
| U District Physical Therapy and Institute of Sports Performance | Physical Therapist | Current |
Accepting new patients |
Locations
707 S Park St
Deer Park, WA 99006
Phone (509) 276-8811
730 N Hamilton St
Spokane, WA 99202
Phone (509) 458-7686
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 60539729 | WA | Yes |
Addresses
Primary practice location
707 S Park St
Deer Park, WA 99006-7025
Mailing address
707 S Park St
Deer Park, WA 99006-7025
Phone (509) 276-8811
Other providers in Deer Park, WA
- Heather A Homchick
- Katie M Hough
- Therese Barker Hubbard
- Delsah Joy Ihrig
- Inland Northwest Renal Care Group, LLC
- Elaine Isaacson
- Jacquelynn Kuhn Counseling & Consulting, PLLC
- Lora Lee Jasman
- Jen'S Aloha Massage
- Jay Daniel Jensen
All providers in Deer Park, WA · Physical Therapist in Washington
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 16, 2016. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.