Active NPI
Martha Elizabeth Glenn, DPT
- Physical Therapist
- Bonney Lake, WA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- PT60093163
- Practice address
- 19820 Sr 410 E
Suite 201
Bonney Lake, WA 98391-6377 - Phone
- (253) 863-7510
- Fax
- (253) 863-5970
- NPI assigned
- Aug 20, 2009
- 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 | PT60093163 | WA | Primary |
Addresses
Primary practice location
19820 Sr 410 E
Suite 201
Bonney Lake, WA 98391-6377
Mailing address
PO Box 2170
Sumner, WA 98390-0480
Phone (253) 863-7510
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in WA
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Physical Therapist in Private Practice
- Education
- Other, 2009
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
3209 S 23Rd St
Suite 100
Tacoma, WA 98405-1602
Phone (253) 459-8174
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PT60093163 | WA | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Multicare Health System | Current | Accepting new patients | |
| Multicare Health System | Current | Accepting new patients | |
| Multicare Health System | Current | Accepting new patients | |
| PT Solutions Management, LLC | Physical Therapist | Past | Accepting new patients |
| Apple Physical Therapy LLC | Physical Therapist | Past | Accepting new patients |
Locations
202 N Division St
Ste 200
Auburn, WA 98001
Phone (253) 333-1637
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
3209 S 23rd St
Ste 100
Tacoma, WA 98405
Phone (253) 459-6999
Organizations & group practices 5
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.
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Physical Therapist
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NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1250726400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1250726400000",
"number": "1154553451",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 2170",
"city": "SUMNER",
"state": "WA",
"postal_code": "983900480",
"telephone_number": "253-863-7510",
"fax_number": "253-840-6340"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "19820 SR 410 E",
"address_2": "SUITE 201",
"city": "BONNEY LAKE",
"state": "WA",
"postal_code": "983916377",
"telephone_number": "253-863-7510",
"fax_number": "253-863-5970"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GLENN",
"first_name": "MARTHA",
"middle_name": "ELIZABETH",
"credential": "DPT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2009-08-20",
"last_updated": "2009-08-20",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "WA",
"license": "PT60093163",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Bonney Lake, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 20, 2009; 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.