Active NPI
Tracy Lynn Hendershott, PT
- Physical Therapist
- Woodinville, WA
National Provider Identifier
1356375224
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- PT00005971
- Practice address
- 17330 135TH Ave NE
Suite 1C
Woodinville, WA 98072 - Phone
- (425) 481-0236
- Fax
- (425) 481-8266
- NPI assigned
- Jul 10, 2006
- Sex
- Female
- 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 | PT00005971 | WA | Primary |
Addresses
Primary practice location
17330 135TH Ave NE
Suite 1C
Woodinville, WA 98072
Mailing address
1314 4TH Place
Kirkland, WA 98033
Phone (425) 576-1046
Other identifiers 7
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 911400843 | Other | BLUE CROSS | |
| 911400843 | Other | COMMERCIAL | |
| 0168528 | Other | WA | LABOR AND INDUSTRIES |
| 4304HE | Other | BLUE SHIELD | |
| 8341588 | Medicaid | WA | |
| 8932338 | Other | WA | CRIME VICTIMS INSURANCE |
| 911400843 | Other | AETNA |
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)
- Enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1152489600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1281398400000",
"number": "1356375224",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1314 4TH PLACE",
"city": "KIRKLAND",
"state": "WA",
"postal_code": "98033",
"telephone_number": "425-576-1046"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "17330 135TH AVE NE",
"address_2": "SUITE 1C",
"city": "WOODINVILLE",
"state": "WA",
"postal_code": "98072",
"telephone_number": "425-481-0236",
"fax_number": "425-481-8266"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HENDERSHOTT",
"first_name": "TRACY",
"middle_name": "LYNN",
"credential": "PT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-07-10",
"last_updated": "2010-08-10",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "WA",
"license": "PT00005971",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS",
"identifier": "911400843",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "COMMERCIAL",
"identifier": "911400843",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "LABOR AND INDUSTRIES",
"identifier": "0168528",
"state": "WA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE SHIELD",
"identifier": "4304HE",
"state": null
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "8341588",
"state": "WA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CRIME VICTIMS INSURANCE",
"identifier": "8932338",
"state": "WA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AETNA",
"identifier": "911400843",
"state": null
}
],
"endpoints": [],
"other_names": []
}Other providers in Woodinville, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 10, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.