Mallory Matteo

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

PT6975244 Issued in WA

Practice address

1908 George Washington Way Ste B
Richland, WA 99354-2386

Phone

(509) 375-1015

Fax

(509) 375-1381

NPI assigned

Apr 27, 2015

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Northwest Center for Sports Medicine & Physical Therapy, Inc.

  • Physical Therapist
  • Gig Harbor, WA
  • NPI 1982755070
  NPD
• Peak Physical Therapy P C

  • Physical Therapist
  • Boise, ID
  • NPI 1073551560
  NPD
• Sport & Spine Therapy of Marin Inc

  • Orthopedic Physical Therapist
  • San Anselmo, CA
  • NPI 1154388577
  NPD
• Sport & Spine Therapy of Marin Inc

  • Orthopedic Physical Therapist
  • Novato, CA
  • NPI 1174578199
  NPD
• Connecticut Orthopaedic Specialists, PC

  • Orthopaedic Surgery Physician
  • Hamden, CT
  • NPI 1235181389

  Physical Therapist

  NPD (past)

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

{
    "created_epoch": "1430092800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1563494400000",
    "number": "1205213451",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6825 BURDEN BLVD STE D",
            "city": "PASCO",
            "state": "WA",
            "postal_code": "993015633",
            "telephone_number": "509-416-0444",
            "fax_number": "509-545-1112"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1908 GEORGE WASHINGTON WAY STE B",
            "city": "RICHLAND",
            "state": "WA",
            "postal_code": "993542386",
            "telephone_number": "509-375-1015",
            "fax_number": "509-375-1381"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "255 N Main St",
            "address_purpose": "LOCATION",
            "city": "Bristol",
            "state": "CT",
            "postal_code": "060104972",
            "country_code": "US",
            "telephone_number": "860-589-1881",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MATTEO",
        "first_name": "MALLORY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-04-27",
        "last_updated": "2019-07-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CT",
            "license": "009674",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "WA",
            "license": "PT6975244",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jim Mason
• Massage by Kaylyn
• John Robert Matheson, MD
• Kelly Matheson, DDS
• Lauren Mathison, M.A.
• Skylar James Matulich, LMT
• Kelly Eileen Mauss, PHYSICAL THERAPIST
• Ellen Jean May, LMT
• Gregory May
• Hyeyoung May

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 19, 2019; 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.