NPIMap

Organization Active NPI

Physical Therapy Associates of Camas

  • Physical Therapy Clinic/Center
  • Camas, WA
National Provider Identifier
1154574614
Registry record updated Nov 11, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy Clinic/CenterTaxonomy code 261QP2000X
License
00008543 Issued in WA
Legal business name
PHYSICAL THERAPY ASSOCIATES OF CAMAS
Practice address
414 NE 3Rd Ave
Camas, WA 98607-2154
Phone
(360) 834-7760
Fax
(360) 834-2756
NPI assigned
Oct 28, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 11, 2008

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

Authorized official

Name
Mr. Willie Guy Sandry, MPT, CSCSNPI 1396962437
Title
President
Phone
(360) 834-7760

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Clinic/Center 261QP2000X 00008543 WA Primary

Addresses

Primary practice location

414 NE 3Rd Ave
Camas, WA 98607-2154

Mailing address

1918 SE 283Rd Ave
Camas, WA 98607-9509
Phone (360) 834-7760

Other identifiers 2

IdentifierTypeStateIssuer
7111628MedicaidWA
261Q00000XOtherWATAXONOMY

National Provider Directory

National Provider Directory

Locations

414 NE 3rd Ave
Camas, WA 98607
Phone (360) 834-7760

318 NE 5th Ave
Camas, WA 98607
Phone (360) 834-7760

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1225152000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1226361600000",
    "number": "1154574614",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1918 SE 283RD AVE",
            "city": "CAMAS",
            "state": "WA",
            "postal_code": "986079509",
            "telephone_number": "360-834-7760",
            "fax_number": "360-834-2756"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "414 NE 3RD AVE",
            "city": "CAMAS",
            "state": "WA",
            "postal_code": "986072154",
            "telephone_number": "360-834-7760",
            "fax_number": "360-834-2756"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PHYSICAL THERAPY ASSOCIATES OF CAMAS",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-10-28",
        "last_updated": "2008-11-11",
        "status": "A",
        "authorized_official_last_name": "SANDRY",
        "authorized_official_first_name": "WILLIE",
        "authorized_official_middle_name": "GUY",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "360-834-7760",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "MPT, CSCS"
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": "WA",
            "license": "00008543",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7111628",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TAXONOMY",
            "identifier": "261Q00000X",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Camas, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 11, 2008; 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.