Individual provider Active NPI

Lauren Summerville

  • Physical Therapist
  • Kent, WA
National Provider Identifier
1114601044
Registry record updated Jan 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT70063671 Issued in WA
Practice address
25615 104TH Ave SE
Kent, WA 98030-7609
Phone
(253) 872-2030
Fax
(253) 872-2550
NPI assigned
Jun 12, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 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 PT70063671 WA Primary

Addresses

Primary practice location

25615 104TH Ave SE
Kent, WA 98030-7609

Mailing address

PO Box 5299
Ms: 820-5-Pco
Tacoma, WA 98415-0299

Other practice location 1

6805 Industrial Rd Ste 3100
Springfield, VA 22151-4206
Phone (703) 256-2171

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20260122003276 WA Practitioner - Physical Therapist in Private Practice 5597242354 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Multicare Health SystemGroup PAC ID 7719899897, 2,312 clinicians

Practice addresses (Care Compare)

25615 104TH Ave SE
Kent, WA 98030-7609
Phone (253) 872-2030

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PT70063671WAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Multicare Health System Physical Therapist CurrentSince Jan 2, 2026 Accepting new patients
Multicare Health System CurrentSince Jan 2, 2026 Accepting new patients
Multicare Health System Physical Therapist Past Accepting new patients

Locations

4700 Point Fosdick Dr
Ste 104
Gig Harbor, WA 98335
Phone (253) 459-7590

222 State Ave N
Kent, WA 98030
Phone (253) 372-7680

25615 104th Ave SE
Kent, WA 98030
Phone (253) 872-2030

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": "1686528000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1768262400000",
    "number": "1114601044",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 5299",
            "address_2": "MS: 820-5-PCO",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "984150299"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25615 104TH AVE SE",
            "city": "KENT",
            "state": "WA",
            "postal_code": "980307609",
            "telephone_number": "253-872-2030",
            "fax_number": "253-872-2550"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6805 Industrial Rd Ste 3100",
            "address_purpose": "LOCATION",
            "city": "Springfield",
            "state": "VA",
            "postal_code": "221514206",
            "country_code": "US",
            "telephone_number": "703-256-2171",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SUMMERVILLE",
        "first_name": "LAUREN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-06-12",
        "last_updated": "2026-01-13",
        "certification_date": "2026-01-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "WA",
            "license": "PT70063671",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kent, WA

Sources for this page

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