Cleo B Bloomquist, PT

Primary specialty

Pediatric Physical TherapistTaxonomy code 2251P0200X

License

PT00003405 Issued in WA

Practice address

16030 Bothell Everett Hwy Ste 140
Mill Creek, WA 98012-1273

Phone

(425) 338-9005

Fax

(426) 337-0931

NPI assigned

Jul 4, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• Cleo Bettinger Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1151971200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1265462147",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8510 186TH ST SW",
            "city": "EDMONDS",
            "state": "WA",
            "postal_code": "980265733",
            "telephone_number": "425-778-2084"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16030 BOTHELL EVERETT HWY STE 140",
            "city": "MILL CREEK",
            "state": "WA",
            "postal_code": "980121273",
            "telephone_number": "425-338-9005",
            "fax_number": "426-337-0931"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLOOMQUIST",
        "first_name": "CLEO",
        "middle_name": "B",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-04",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2251P0200X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Pediatrics",
            "state": "WA",
            "license": "PT00003405",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "REGENCE PIN#",
            "identifier": "BL5114",
            "state": "WA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8367559",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CLEO",
            "last_name": "BETTINGER",
            "credential": "PT",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Bill J. Mulliken DDS, P.S.
• Jeffrey Bissey, MD
• BJ Mulliken DDS PLLC
• Brenda Lynn Black, AT,C
• Gwendolyn Black, LPN
• Bmi DC PS
• Swapna J Bobba, M.D.
• Bridgett Bodine
• Anne-Marie Bollen, DDS, MS, PHD
• Shelley J Bond, L.M.P.

• Pediatric Physical Therapist in Mill Creek, WA
• Providers in Mill Creek, WA by specialty
• Pediatric Physical Therapist in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 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.