Individual provider Active NPI

Shawn Timothy Quenga, D.P.T.

  • Physical Therapist
  • University Place, WA
National Provider Identifier
1265451306
Registry record updated Sep 18, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT00010145 Issued in WA
Practice address
4606 Bridgeport Way W
Suite C
University Place, WA 98466-4200
Phone
(253) 565-3551
Fax
(253) 565-4535
NPI assigned
Jul 19, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 18, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X PT00010145 WA Primary

Addresses

Primary practice location

4606 Bridgeport Way W
Suite C
University Place, WA 98466-4200

Mailing address

4606 Bridgeport Way W
Suite C
University Place, WA 98466-4200
Phone (253) 565-3551

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070710000750 WA Practitioner - Physical Therapist in Private Practice 2163522830 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Quenga Hanson and Purdue PS IncGroup PAC ID 0143576298, 2 clinicians

Practice addresses (Care Compare)

4606 Bridgeport Way W
Suite C
University Place, WA 98466-4200
Phone 25356535511

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PT00010145WAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Ross M. Anderson, Anchor Physical Therapy Physical Therapist CurrentSince Mar 18, 2015 Accepting new patients
Quenga, Hanson and Purdue, P.S., Inc. Physical Therapist CurrentSince Apr 23, 2018 Accepting new patients

Locations

1407 E 72nd St
Ste A100
Tacoma, WA 98404
Phone (253) 474-7474

4606 Bridgeport Way W
Ste C
University Place, WA 98466
Phone (253) 565-3551

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1153267200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1758153600000",
    "number": "1265451306",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4606 BRIDGEPORT WAY W",
            "address_2": "SUITE C",
            "city": "UNIVERSITY PLACE",
            "state": "WA",
            "postal_code": "984664200",
            "telephone_number": "253-565-3551",
            "fax_number": "253-565-4535"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4606 BRIDGEPORT WAY W",
            "address_2": "SUITE C",
            "city": "UNIVERSITY PLACE",
            "state": "WA",
            "postal_code": "984664200",
            "telephone_number": "253-565-3551",
            "fax_number": "253-565-4535"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "QUENGA",
        "first_name": "SHAWN",
        "middle_name": "TIMOTHY",
        "credential": "D.P.T.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-19",
        "last_updated": "2025-09-18",
        "certification_date": "2025-09-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "WA",
            "license": "PT00010145",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in University Place, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 18, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.