Alexander Wirta, PT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

PT 60555817 Issued in WA

Practice address

19017 120TH Ave NE BLDG 1
Suite 111
Bothell, WA 98011-9510

Phone

(425) 489-3420

Fax

(425) 489-3421

NPI assigned

Sep 3, 2015

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Therapeutic Associates Inc

  • Physical Therapist
  • Bothell, WA
  • NPI 1114376563
  NPD (past)
• Therapeutic Associates Inc

  • Physical Therapist
  • Portland, OR
  • NPI 1700862000
  NPD (past)

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

{
    "created_epoch": "1441238400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1493769600000",
    "number": "1134597404",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16083 SW UPPER BOONES FERRY RD",
            "address_2": "SUITE 300",
            "city": "TIGARD",
            "state": "OR",
            "postal_code": "972247736",
            "telephone_number": "800-219-8835",
            "fax_number": "503-639-9699"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19017 120TH AVE NE BLDG 1",
            "address_2": "SUITE 111",
            "city": "BOTHELL",
            "state": "WA",
            "postal_code": "980119510",
            "telephone_number": "425-489-3420",
            "fax_number": "425-489-3421"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WIRTA",
        "first_name": "ALEXANDER",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-09-03",
        "last_updated": "2017-05-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "WA",
            "license": "PT 60555817",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1134597404",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Julia Nadine Wilson, PA-C
• Karol A. Wilson, PT
• Kori Ann Wilson, OTR/L
• Thomas A Wilson, M.D.
• Amy Alger Wilter, PHD, LMHC
• Amanda Wodzinski, OTR/L
• Andrew Michael Wojcik
• Charis M Wolf, L AC
• Julie Wolfe, R.N.
• Mary Beth Woll, RC

• Physical Therapist in Bothell, WA
• Providers in Bothell, WA by specialty
• Physical Therapist in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 3, 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.

Verify at the official NPI Registry.