Fallon L Frederick, PTA

Primary specialty

Physical Therapy AssistantTaxonomy code 225200000X

License

P160900331 Issued in WA

Practice address

2821 S Walden St
Seattle, WA 98144-6830

Phone

(206) 577-6200

NPI assigned

Jan 13, 2019

Last updated

Jan 13, 2019By the provider in NPPES

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1547337600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1547337600000",
    "number": "1295209245",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25117 SW PARKWAY AVE STE D",
            "city": "WILSONVILLE",
            "state": "OR",
            "postal_code": "970709697"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2821 S WALDEN ST",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981446830",
            "telephone_number": "206-577-6200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FREDERICK",
        "first_name": "FALLON",
        "middle_name": "L",
        "name_prefix": "Mrs.",
        "credential": "PTA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-01-13",
        "last_updated": "2019-01-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "WA",
            "license": "P160900331",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Grace Fredeen, CO
• Jamie Fredeen, LMFTA, MHP
• Kate Jeanine Fredenberg, LICSW, CDP
• Frederick B Davis MD PS
• Christina Frederick, MD, MPH
• James Todd Frederick, D.C.
• John Thomas Frederick, MD
• Shanna E Frederick, DC
• Julia Nancy Fredericks, DMD
• Margo Badman Fredericks, FNP-BC, ARNP

• Physical Therapy Assistant in Seattle, WA
• Providers in Seattle, WA by specialty
• Physical Therapy Assistant in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 13, 2019; 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.