NPIMap

Organization Active NPI

Pacific Physical Therapy PLLC

  • Physical Therapy Clinic/Center
  • Silverdale, WA
National Provider Identifier
1104568179
Registry record updated Apr 11, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy Clinic/CenterTaxonomy code 261QP2000X
Legal business name
PACIFIC PHYSICAL THERAPY PLLC
Practice address
3114 NW Randall Way Ste 300
Silverdale, WA 98383-7676
Phone
(360) 625-9161
Fax
(360) 625-9215
NPI assigned
Apr 11, 2022
Organization subpart
Yes
Parent organization
PACIFIC PHYSICAL THERAPY PLLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Apr 11, 2022

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

Authorized official

Name
Lauren M Palmer
Title
Office Manager
Phone
(360) 329-7052

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Clinic/Center 261QP2000X Primary

Addresses

Primary practice location

3114 NW Randall Way Ste 300
Silverdale, WA 98383-7676

Mailing address

1950 Pottery Ave Ste 110
Port Orchard, WA 98366-2501
Phone (360) 329-7052

Other identifiers 1

IdentifierTypeStateIssuer
2041063MedicaidWA

National Provider Directory

National Provider Directory
Tax ID family
Pacific Physical Therapy PLLC2 organizations share this tax ID, including this one
Part of
Pacific Physical Therapy PLLC

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

1950 Pottery Ave
Ste 110
Port Orchard, WA 98366
Phone (360) 329-7052

3114 NW Randall Way
#300Ste
Silverdale, WA 98383
Phone (360) 625-9161

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

Practitioners & affiliated clinicians

Practitioners 15

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 15

NPI Registry JSON

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

{
    "created_epoch": "1649635200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1649635200000",
    "number": "1104568179",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1950 POTTERY AVE STE 110",
            "city": "PORT ORCHARD",
            "state": "WA",
            "postal_code": "983662501",
            "telephone_number": "360-329-7052",
            "fax_number": "360-329-7053"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3114 NW RANDALL WAY STE 300",
            "city": "SILVERDALE",
            "state": "WA",
            "postal_code": "983837676",
            "telephone_number": "360-625-9161",
            "fax_number": "360-625-9215"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PACIFIC PHYSICAL THERAPY PLLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "PACIFIC PHYSICAL THERAPY PLLC",
        "enumeration_date": "2022-04-11",
        "last_updated": "2022-04-11",
        "certification_date": "2022-04-11",
        "status": "A",
        "authorized_official_last_name": "PALMER",
        "authorized_official_first_name": "LAUREN",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "360-329-7052"
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2041063",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Silverdale, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 11, 2022; 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.