Active NPI
Mary Brophy, PT
- Pediatric Physical Therapist
- Vancouver, WA
National Provider Identifier
1235477803
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Physical Therapist
- License
- PT 9829
- Practice address
- 13501 NE 28TH St
Vancouver, WA 98682-8091 - Phone
- (360) 604-1001
- NPI assigned
- Jan 16, 2013
- 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 |
|---|---|---|---|---|
| Pediatric Physical Therapist | 2251P0200X | PT 9829 | WA | Primary |
Addresses
Primary practice location
13501 NE 28TH St
Vancouver, WA 98682-8091
Mailing address
3407 SE 172ND Ave
Vancouver, WA 98683-9451
Phone (360) 254-0090
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 |
|---|---|---|---|
| PT 9829 | WA | MD | Pediatric Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1358294400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1358294400000",
"number": "1235477803",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3407 SE 172ND AVE",
"city": "VANCOUVER",
"state": "WA",
"postal_code": "986839451",
"telephone_number": "360-254-0090"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "13501 NE 28TH ST",
"city": "VANCOUVER",
"state": "WA",
"postal_code": "986828091",
"telephone_number": "360-604-1001"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BROPHY",
"first_name": "MARY",
"name_prefix": "Ms.",
"credential": "PT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2013-01-16",
"last_updated": "2013-01-16",
"status": "A"
},
"taxonomies": [
{
"code": "2251P0200X",
"taxonomy_group": "",
"desc": "Physical Therapist, Pediatrics",
"state": "WA",
"license": "PT 9829",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Vancouver, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 16, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.