Active NPI
Susan Marie Fletcher, MSPT, DPT
- Physical Therapist
- Mercer Island, WA
National Provider Identifier
1255599247
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- PT00009716
- Practice address
- 2929 76TH Ave SE Apt 212
Mercer Island, WA 98040-2785 - Phone
- (425) 691-0777
- NPI assigned
- May 28, 2008
- 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 Therapist | 225100000X | PT00009716 | WA | Primary |
Addresses
Primary practice location
2929 76TH Ave SE Apt 212
Mercer Island, WA 98040-2785
Mailing address
10600 Wilkins Ave
1B
Los Angeles, CA 90024-6078
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 |
|---|---|---|---|
| PT00009716 | WA | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1211932800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1211932800000",
"number": "1255599247",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "10600 WILKINS AVE",
"address_2": "1B",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900246078"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2929 76TH AVE SE APT 212",
"city": "MERCER ISLAND",
"state": "WA",
"postal_code": "980402785",
"telephone_number": "425-691-0777"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FLETCHER",
"first_name": "SUSAN",
"middle_name": "MARIE",
"credential": "MSPT, DPT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2008-05-28",
"last_updated": "2008-05-28",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "WA",
"license": "PT00009716",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Mercer Island, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 28, 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.