Active NPI
Laura E Broudy, DPT
- Physical Therapist
- Mercer Island, WA
National Provider Identifier
1114443355
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- PT60749753
- Practice address
- 7900 SE 28TH St Ste 102
Mercer Island, WA 98040-2970 - Phone
- (206) 232-9045
- Fax
- (206) 232-8871
- NPI assigned
- Aug 18, 2017
- Last updated
- Aug 18, 2017
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | PT60749753 | WA | Primary |
Addresses
Primary practice location
7900 SE 28TH St Ste 102
Mercer Island, WA 98040-2970
Mailing address
2231 32ND Ave S
Seattle, WA 98144-4953
Phone (206) 723-3640
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| PENDING | Medicaid | WA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PT60749753 | WA | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1503014400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1503014400000",
"number": "1114443355",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2231 32ND AVE S",
"city": "SEATTLE",
"state": "WA",
"postal_code": "981444953",
"telephone_number": "206-723-3640"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "7900 SE 28TH ST STE 102",
"city": "MERCER ISLAND",
"state": "WA",
"postal_code": "980402970",
"telephone_number": "206-232-9045",
"fax_number": "206-232-8871"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BROUDY",
"first_name": "LAURA",
"middle_name": "E",
"credential": "DPT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2017-08-18",
"last_updated": "2017-08-18",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "WA",
"license": "PT60749753",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "PENDING",
"state": "WA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Mercer Island, WA
- Alayna Brauer, LMP
- Bridge Physical Therapy and Wellness
- Laura Ann-Marie Bright-Tobin, LMP
- Bronzewing Corp (Firstlight Home Care of Mercer Island)
- Brook Medical Services PLLC
- Mary Patricia Browning, ND
- Mary Jo Starck Bruckner, MS, CCC-SP
- Melony O'Neill Cable, LAC
- Casey Campbell, DC
- Cara Erkut, MD PLLC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 18, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.