NPIMap

Organization Active NPI

Cascade Physical Therapy & Sports Clinic

  • Physical Therapist
  • Sedro Woolley, WA
National Provider Identifier
1306980537
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT00000529 Issued in WA
Legal business name
CASCADE PHYSICAL THERAPY & SPORTS CLINIC
Practice address
210 Ferry St
Sedro Woolley, WA 98284-1411
Phone
(360) 856-4216
NPI assigned
Feb 19, 2007
Last updated
Aug 22, 2020By the provider in NPPES
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
Harold G. Vonbergen, P.T.NPI 1124020268
Title
Owner
Phone
(360) 856-4216

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 SINGLE SPECIALTY GROUP 225100000X PT00000529 WA Primary

Addresses

Primary practice location

210 Ferry St
Sedro Woolley, WA 98284-1411

Mailing address

210 Ferry St
Sedro Woolley, WA 98284-1411

National Provider Directory

National Provider Directory

Locations

210 Ferry St
Sedro Woolley, WA 98284
Phone (360) 856-4216

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1171843200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1306980537",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "210 FERRY ST",
            "city": "SEDRO WOOLLEY",
            "state": "WA",
            "postal_code": "982841411"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "210 FERRY ST",
            "city": "SEDRO WOOLLEY",
            "state": "WA",
            "postal_code": "982841411",
            "telephone_number": "360-856-4216"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CASCADE PHYSICAL THERAPY & SPORTS CLINIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-19",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "VONBERGEN",
        "authorized_official_first_name": "HAROLD",
        "authorized_official_middle_name": "G.",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "360-856-4216",
        "authorized_official_credential": "P.T."
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist",
            "state": "WA",
            "license": "PT00000529",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sedro Woolley, 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.