Active NPI
Theodore J. Becker, PHD
- Physical Therapist
- Everett, WA
National Provider Identifier
1336539428
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- PT0003086
- Practice address
- 11627 Airport Rd Ste H
Everett, WA 98204-8714 - Phone
- (425) 353-9300
- Fax
- (425) 290-3688
- NPI assigned
- Jan 28, 2015
- Last updated
- Jan 28, 2015
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | PT0003086 | WA | Primary |
Addresses
Primary practice location
11627 Airport Rd Ste H
Everett, WA 98204-8714
Mailing address
5213 23Rd Ave W
Everett, WA 98203-1557
Phone (425) 353-9300
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PT0003086 | WA | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1422403200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1422403200000",
"number": "1336539428",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5213 23RD AVE W",
"city": "EVERETT",
"state": "WA",
"postal_code": "982031557",
"telephone_number": "425-353-9300",
"fax_number": "425-290-3688"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "11627 AIRPORT RD STE H",
"city": "EVERETT",
"state": "WA",
"postal_code": "982048714",
"telephone_number": "425-353-9300",
"fax_number": "425-290-3688"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BECKER",
"first_name": "THEODORE",
"middle_name": "J.",
"name_prefix": "Dr.",
"credential": "PHD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2015-01-28",
"last_updated": "2015-01-28",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "WA",
"license": "PT0003086",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Everett, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 28, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.