Individual provider Active NPI

Lisa Thu Hong, PT

  • Physical Therapist
  • Everett, WA
National Provider Identifier
1114907003
Registry record updated Jan 9, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT00010005 Issued in WA
Practice address
1615 75TH St SW # S
Everett, WA 98203-6293
Phone
(425) 261-4780
Fax
(425) 261-4720
NPI assigned
Jan 18, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 9, 2025

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 PT00010005 WA Primary

Addresses

Primary practice location

1615 75TH St SW # S
Everett, WA 98203-6293

Mailing address

1615 75TH St SW Ste 210
Everett, WA 98203-6293
Phone (425) 261-4780

Other identifiers 1

IdentifierTypeStateIssuer
8443814MedicaidWA

Other names 1

  • Lisa Thu Thao Hong Former name

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

LicenseStateTypeSpecialty
PT00010005WAMDPhysical Therapist

NPI Registry JSON

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

{
    "created_epoch": "1137542400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1736380800000",
    "number": "1114907003",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1615 75TH ST SW STE 210",
            "city": "EVERETT",
            "state": "WA",
            "postal_code": "982036293",
            "telephone_number": "425-261-4780",
            "fax_number": "425-261-4720"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1615 75TH ST SW # S",
            "city": "EVERETT",
            "state": "WA",
            "postal_code": "982036293",
            "telephone_number": "425-261-4780",
            "fax_number": "425-261-4720"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HONG",
        "first_name": "LISA",
        "middle_name": "THU",
        "name_prefix": "Ms.",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-01-18",
        "last_updated": "2025-01-09",
        "certification_date": "2025-01-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "WA",
            "license": "PT00010005",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8443814",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LISA",
            "last_name": "THAO HONG",
            "middle_name": "THU",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Everett, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 9, 2025; 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.