Active NPI
Sabrina Rose Broach
- Physical Therapy Assistant
- Seattle, WA
National Provider Identifier
1225348170
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapy Assistant
- License
- P160039301
- Practice address
- 3540 NE 110TH St.
Seattle, WA 98125 - Phone
- (206) 367-1004
- Fax
- (206) 363-1876
- NPI assigned
- Oct 13, 2010
- 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 Therapy Assistant | 225200000X | P160039301 | WA | Primary |
Addresses
Primary practice location
3540 NE 110TH St.
Seattle, WA 98125
Mailing address
4560 SE International Way
Ste. 100
Milwaukie, OR 97222
Phone (971) 206-5200
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| P160039301 | WA | MD | Physical Therapy Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1286928000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1286928000000",
"number": "1225348170",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4560 SE INTERNATIONAL WAY",
"address_2": "STE. 100",
"city": "MILWAUKIE",
"state": "OR",
"postal_code": "97222",
"telephone_number": "971-206-5200",
"fax_number": "971-206-5203"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3540 NE 110TH ST.",
"city": "SEATTLE",
"state": "WA",
"postal_code": "98125",
"telephone_number": "206-367-1004",
"fax_number": "206-363-1876"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BROACH",
"first_name": "SABRINA",
"middle_name": "ROSE",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2010-10-13",
"last_updated": "2010-10-13",
"status": "A"
},
"taxonomies": [
{
"code": "225200000X",
"taxonomy_group": "",
"desc": "Physical Therapy Assistant",
"state": "WA",
"license": "P160039301",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Seattle, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 13, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.