Madrona Physical Therapy, PLLC

Primary specialty

Physical TherapistTaxonomy code 225100000X

Legal business name

MADRONA PHYSICAL THERAPY, PLLC

Doing business as

Madrona Physical Therapy, PLLC

Practice address

4701 S 19TH St Ste 100
Tacoma, WA 98405-1199

Phone

(253) 212-3620

Fax

(253) 301-2088

NPI assigned

Aug 26, 2021

Organization subpart

No

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

Authorized official

Name

Dr. Angela Maxwell, PT

Title

Clinic Director

Phone

(253) 212-3620

Specialties & licenses 1

Addresses

Other names 1

• Madrona Physical Therapy, PLLC Doing business as

Practitioners 1

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

• Derek Robert Straus, PT, DPT

  • Physical Medicine & Rehabilitation Physician
  • Lacey, WA
  • NPI 1407462518
  NPD

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

{
    "created_epoch": "1629936000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1629936000000",
    "number": "1104593151",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4701 S 19TH ST STE 100",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "984051199",
            "telephone_number": "253-212-3620",
            "fax_number": "253-301-2088"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4701 S 19TH ST STE 100",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "984051199",
            "telephone_number": "253-212-3620",
            "fax_number": "253-301-2088"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MADRONA PHYSICAL THERAPY, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-08-26",
        "last_updated": "2021-08-26",
        "certification_date": "2021-08-26",
        "status": "A",
        "authorized_official_last_name": "MAXWELL",
        "authorized_official_first_name": "ANGELA",
        "authorized_official_title_or_position": "CLINIC DIRECTOR",
        "authorized_official_telephone_number": "253-212-3620",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PT"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Madrona Physical Therapy, PLLC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Ryan Edward Madison, PT, MS
• Jayson Madriaga, PA-C
• Ivonne Rosa Madrigal Leon
• Madrona Peak LLC
• Madrona Pelvic Health, LLC
• Grace Amalachukwu Madueke, PMHNP
• Johnette Barnes Maehren, D.O.
• Paul Maestry-Williams
• Sophia Irene Maffei
• Bernard Magbe, PHARMACIST

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 26, 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.