Marijke Augusta Edwards, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

PT60917166 Issued in WA

Practice address

463 Tremont St W Ste 100
Port Orchard, WA 98366-3743

Phone

(360) 874-0745

Fax

(360) 874-0846

NPI assigned

Jan 4, 2019

Last updated

Dec 1, 2021By the provider in NPPES

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 identifiers 1

Other names 1

• Marijke Augusta De Koning Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

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

{
    "created_epoch": "1546560000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1638316800000",
    "number": "1104399815",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 NW NICHOLS AVE",
            "city": "BREMERTON",
            "state": "WA",
            "postal_code": "983112423",
            "telephone_number": "619-417-0389"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "463 TREMONT ST W STE 100",
            "city": "PORT ORCHARD",
            "state": "WA",
            "postal_code": "983663743",
            "telephone_number": "360-874-0745",
            "fax_number": "360-874-0846"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EDWARDS",
        "first_name": "MARIJKE",
        "middle_name": "AUGUSTA",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-01-04",
        "last_updated": "2021-12-01",
        "certification_date": "2021-12-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "WA",
            "license": "PT60917166",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PT LICENSE",
            "identifier": "PT60917166",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MARIJKE",
            "last_name": "DE KONING",
            "middle_name": "AUGUSTA",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Acacia Grace Dyer, DPT
• Natasha Rae Eason, SUDPT
• Tisha Jolene Eby
• Carol Jean Eddy, CD (DONA)
• Nora Sofia Edge
• Pamela S E Edwards, RPH
• Heidi Michelle Ehlert Nordby, L.M.P.
• Emily Ann Ellis
• Kayla Marie Ellison
• Emily Emerson, AARC

• Physical Therapist in Port Orchard, WA
• Providers in Port Orchard, WA by specialty
• Physical Therapist in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 1, 2021; 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.