Individual provider Active NPI

David John Marshall

  • Physical Therapy Assistant
  • Seattle, WA
National Provider Identifier
1124289574
Registry record updated Apr 23, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy AssistantTaxonomy code 225200000X
License
60043601 Issued in WA
Practice address
12505 Greenwood Ave N
Seattle, WA 98133-8040
Phone
(206) 536-2616
NPI assigned
Jun 18, 2008
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 23, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy AssistantGroup: 193400000X SINGLE SPECIALTY GROUP 225200000X 60043601 WA Primary

Addresses

Primary practice location

12505 Greenwood Ave N
Seattle, WA 98133-8040

Mailing address

513 NE 179TH PL
Shoreline, WA 98155-3609
Phone (206) 313-9600

Other practice location 1

Bayview Manor
11 West Aloha Street
Seattle, Washington 98119
TM
Phone (206) 691-5340

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
60043601WAMDPhysical Therapy Assistant

NPI Registry JSON

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

{
    "created_epoch": "1213747200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1619136000000",
    "number": "1124289574",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "513 NE 179TH PL",
            "city": "SHORELINE",
            "state": "WA",
            "postal_code": "981553609",
            "telephone_number": "206-313-9600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12505 GREENWOOD AVE N",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981338040",
            "telephone_number": "206-536-2616"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "Bayview Manor",
            "address_2": "11 West Aloha Street",
            "address_purpose": "LOCATION",
            "city": "Seattle",
            "state": "Washington",
            "postal_code": "98119",
            "country_code": "TM",
            "telephone_number": "206-691-5340",
            "country_name": "Turkmenistan",
            "address_type": "FGN"
        }
    ],
    "basic": {
        "last_name": "MARSHALL",
        "first_name": "DAVID",
        "middle_name": "JOHN",
        "name_prefix": "Mr.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-06-18",
        "last_updated": "2021-04-23",
        "certification_date": "2021-04-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapy Assistant",
            "state": "WA",
            "license": "60043601",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Seattle, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 23, 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.