NPIMap

Organization Active NPI

Northwest Pediatric Therapies, PS

  • Physical Therapist
  • Issaquah, WA
National Provider Identifier
1306903877
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT00002750 Issued in WA
Legal business name
NORTHWEST PEDIATRIC THERAPIES, PS
Practice address
710 NW Juniper St
Suite 104
Issaquah, WA 98027-2717
Phone
(425) 392-7989
Fax
(425) 391-2554
NPI assigned
Jan 3, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Ms. Priscilla A Coyner, MASTERS OF PT, PCSNPI 1770627952
Title
President
Phone
(425) 392-7989

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical TherapistGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 225100000X PT00002750 WA Primary

Addresses

Primary practice location

710 NW Juniper St
Suite 104
Issaquah, WA 98027-2717

Mailing address

710 NW Juniper St
Suite 104
Issaquah, WA 98027-2717
Phone (425) 392-7989

Other identifiers 2

IdentifierTypeStateIssuer
7038037MedicaidWA
CO2118OtherWAREGENCE PROVIDER NUMBER

Other names 1

  • Priscilla A Coyner Doing business as

National Provider Directory

National Provider Directory

Locations

710 NW Juniper St
Ste 104
Issaquah, WA 98027
Phone (425) 392-7989

Practitioners & affiliated clinicians

Practitioners 13

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1167782400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1306903877",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "710 NW JUNIPER ST",
            "address_2": "SUITE 104",
            "city": "ISSAQUAH",
            "state": "WA",
            "postal_code": "980272717",
            "telephone_number": "425-392-7989",
            "fax_number": "425-391-2554"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "710 NW JUNIPER ST",
            "address_2": "SUITE 104",
            "city": "ISSAQUAH",
            "state": "WA",
            "postal_code": "980272717",
            "telephone_number": "425-392-7989",
            "fax_number": "425-391-2554"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTHWEST PEDIATRIC THERAPIES, PS",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-03",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "COYNER",
        "authorized_official_first_name": "PRISCILLA",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "425-392-7989",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "MASTERS OF PT, PCS"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Physical Therapist",
            "state": "WA",
            "license": "PT00002750",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7038037",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "REGENCE PROVIDER NUMBER",
            "identifier": "CO2118",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Priscilla A Coyner",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Issaquah, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.