Carolyn O. Miklavic, PT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

PT00010155 Issued in WA

Practice address

1400 King St
Suite 102
Bellingham, WA 98229-6262

Phone

(360) 671-2900

Fax

(360) 671-2828

NPI assigned

Apr 16, 2007

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Healthy Focus PS

  • Specialist
  • Bellingham, WA
  • NPI 1427004407
  NPD (past)
• Northwest Physical Therapy Sports Rehabilitation Center, Inc., P.S.

  • Physical Therapist
  • Mount Vernon, WA
  • NPI 1174523054
  NPD (past)

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

{
    "created_epoch": "1176681600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1192406400000",
    "number": "1235354903",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1400 KING ST",
            "address_2": "SUITE 102",
            "city": "BELLINGHAM",
            "state": "WA",
            "postal_code": "982296262",
            "telephone_number": "360-671-2900",
            "fax_number": "360-671-2828"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1400 KING ST",
            "address_2": "SUITE 102",
            "city": "BELLINGHAM",
            "state": "WA",
            "postal_code": "982296262",
            "telephone_number": "360-671-2900",
            "fax_number": "360-671-2828"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MIKLAVIC",
        "first_name": "CAROLYN",
        "middle_name": "O.",
        "credential": "PT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-04-16",
        "last_updated": "2007-10-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "WA",
            "license": "PT00010155",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8480733",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Lori Savitt Michelson, MSW, LICSW
• Krissa Anne Mickelwait, D.D.S.
• Hiwot Soboksa Mideksa
• Masayoshi Migita, ATC, CSCS
• Angela Michelle Mikeska, OT
• Penny Milczewski
• Beverley Joanne Millan, ARNP
• Nancy Michele Miller Wutzke, P.T.
• Grace Miller-Tran, MSW
• Camille Avina Miller, MD

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 15, 2007; 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.