Aurora Village Physical Therapy, Inc

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

PT00003503 Issued in WA

Legal business name

AURORA VILLAGE PHYSICAL THERAPY, INC

Practice address

1207 N 200TH St
103
Shoreline, WA 98133-3213

Phone

(206) 542-1986

Fax

(206) 542-1144

NPI assigned

Nov 16, 2006

Organization subpart

No

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

Authorized official

Name

Brian Keith Clute, PHYISCAL THERAPIST

Title

Owner

Phone

(206) 542-1986

Specialties & licenses 1

Addresses

Other identifiers 3

Locations

Practitioners 1

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

• Lorraine Mazelis Flaherty, P.T.

  • Physical Therapist
  • Everett, WA
  • NPI 1689785446
  NPD (past)

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

{
    "created_epoch": "1163635200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1471564800000",
    "number": "1326111477",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1207 N 200TH ST",
            "address_2": "103",
            "city": "SHORELINE",
            "state": "WA",
            "postal_code": "981333213",
            "telephone_number": "206-542-1986",
            "fax_number": "206-542-1144"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1207 N 200TH ST",
            "address_2": "103",
            "city": "SHORELINE",
            "state": "WA",
            "postal_code": "981333213",
            "telephone_number": "206-542-1986",
            "fax_number": "206-542-1144"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AURORA VILLAGE PHYSICAL THERAPY, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-16",
        "last_updated": "2016-08-19",
        "status": "A",
        "authorized_official_last_name": "CLUTE",
        "authorized_official_first_name": "BRIAN",
        "authorized_official_middle_name": "KEITH",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "206-542-1986",
        "authorized_official_credential": "PHYISCAL THERAPIST"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist",
            "state": "WA",
            "license": "PT00003503",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LABOR AND INDUSTRIES",
            "identifier": "0148810",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ACS",
            "identifier": "242772700",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SOCIAL & HEALTH SERVICES",
            "identifier": "7061617",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Catherine Joyce Assata, SUDP, LMHCA
• Etsegenet Abate Assefa, PHARMD
• Tamara Zina Anne Atkins, M.D.
• Dawn L Atlas, LMP
• Aurora Oaks, LLC
• Evelina Avetisova, AGPC-NP
• Linda Ruth Ayers
• Christine N Babcock
• Annenelia Bach, LMT
• Emma Badner

• Physical Therapist in Shoreline, WA
• Providers in Shoreline, WA by specialty
• Physical Therapist in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 19, 2016; 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.