Individual provider Active NPI

Mitchell Guy Blakney, P.T.

  • Physical Therapist
  • Gig Harbor, WA
National Provider Identifier
1104852227
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT00002125 Issued in WA
Practice address
4700 Point Fosdick Dr NW
Suite 213
Gig Harbor, WA 98335-1706
Phone
(253) 851-5718
Fax
(253) 853-6922
NPI assigned
Jun 23, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X PT00002125 WA Primary

Addresses

Primary practice location

4700 Point Fosdick Dr NW
Suite 213
Gig Harbor, WA 98335-1706

Mailing address

3716 44TH Street CT NW
Gig Harbor, WA 98335-8277
Phone (253) 858-5465

Other identifiers 1

IdentifierTypeStateIssuer
8336992MedicaidWA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120509000008 WA Practitioner - Physical Therapist in Private Practice 4981596699 Reassigns benefits to 1 organization
Practice locations: Gig Harbor, WA

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 1977
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

3716 44TH St CT
Gig Harbor, WA 98335-8277

5202 Olympic Dr
Suite 100
Gig Harbor, WA 98335-1727
Phone (253) 318-6665

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PT00002125WAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Integrated Rehabilitation Group, PC Physical Therapist CurrentSince Aug 19, 2019 Accepting new patients
Mitchell Blakney PT, PLLC CurrentSince Jan 31, 2021 Accepting new patients
Integrated Rehabilitation Group, PC Physical Therapist CurrentSince Aug 19, 2019 Accepting new patients
Harbor Speech Pathology, PS PastSince Jul 1, 2009 Accepting new patients

Locations

10207 19th Ave SE
Everett, WA 98208
Phone (425) 337-3166

5202 Olympic Dr
Ste 100
Gig Harbor, WA 98335
Phone (253) 318-6665

403 W Stanley St
Granite Falls, WA 98252
Phone (360) 691-4835

4220 132nd St SE
Ste 101
Mill Creek, WA 98012
Phone (425) 316-8046

111 Market St NE
Ste 108
Olympia, WA 98501
Phone (360) 754-7085

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1151020800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1104852227",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3716 44TH STREET CT NW",
            "city": "GIG HARBOR",
            "state": "WA",
            "postal_code": "983358277",
            "telephone_number": "253-858-5465",
            "fax_number": "253-853-6922"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4700 POINT FOSDICK DR NW",
            "address_2": "SUITE 213",
            "city": "GIG HARBOR",
            "state": "WA",
            "postal_code": "983351706",
            "telephone_number": "253-851-5718",
            "fax_number": "253-853-6922"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLAKNEY",
        "first_name": "MITCHELL",
        "middle_name": "GUY",
        "name_prefix": "Mr.",
        "credential": "P.T.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-23",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "WA",
            "license": "PT00002125",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8336992",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Gig Harbor, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.