NPIMap

Organization Active NPI

Scammon Creek Physical Therapy

  • Physical Therapy Clinic/Center
  • Centralia, WA
National Provider Identifier
1164561775
Registry record updated Jun 19, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy Clinic/CenterTaxonomy code 261QP2000X
License
602410734 Issued in WA
Legal business name
SCAMMON CREEK PHYSICAL THERAPY
Practice address
2700 Colonial Dr
#305
Centralia, WA 98531-8869
Phone
(360) 330-9346
Fax
(360) 330-9347
NPI assigned
Feb 6, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 19, 2008

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

Authorized official

Name
Robert Prandi, MSPTNPI 1164554614
Title
Director
Phone
(360) 330-9346

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Clinic/Center 261QP2000X 602410734 WA Primary

Addresses

Primary practice location

2700 Colonial Dr
#305
Centralia, WA 98531-8869

Mailing address

PO Box 383
Littlerock, WA 98556-0383
Phone (360) 330-9346

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1170720000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1213833600000",
    "number": "1164561775",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 383",
            "city": "LITTLEROCK",
            "state": "WA",
            "postal_code": "985560383",
            "telephone_number": "360-330-9346",
            "fax_number": "360-330-9347"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2700 COLONIAL DR",
            "address_2": "#305",
            "city": "CENTRALIA",
            "state": "WA",
            "postal_code": "985318869",
            "telephone_number": "360-330-9346",
            "fax_number": "360-330-9347"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SCAMMON CREEK PHYSICAL THERAPY",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-06",
        "last_updated": "2008-06-19",
        "status": "A",
        "authorized_official_last_name": "PRANDI",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "360-330-9346",
        "authorized_official_credential": "MSPT"
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": "WA",
            "license": "602410734",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Centralia, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 19, 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.