NPIMap

Organization Active NPI

Ocean Beach Physical Therapy Inc

  • Physical Therapist
  • Ilwaco, WA
National Provider Identifier
1356423883
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Legal business name
OCEAN BEACH PHYSICAL THERAPY INC
Practice address
316 1St Ave. North
Ilwaco, WA 98624
Phone
(360) 642-8551
Fax
(360) 642-3408
NPI assigned
Oct 20, 2006
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
Mrs. Victoria M. Vestal, LPT
Title
Owner Administrator
Phone
(360) 642-8551

Specialties & licenses 1

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

Addresses

Primary practice location

316 1St Ave. North
Ilwaco, WA 98624

Mailing address

PO Box 830
Ilwaco, WA 98624-0830
Phone (360) 642-8551

Other identifiers 1

IdentifierTypeStateIssuer
70644140MedicaidWA

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 5

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

NPI Registry JSON

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

{
    "created_epoch": "1161302400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1356423883",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 830",
            "city": "ILWACO",
            "state": "WA",
            "postal_code": "986240830",
            "telephone_number": "360-642-8551",
            "fax_number": "360-642-3408"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "316 1ST AVE. NORTH",
            "city": "ILWACO",
            "state": "WA",
            "postal_code": "98624",
            "telephone_number": "360-642-8551",
            "fax_number": "360-642-3408"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OCEAN BEACH PHYSICAL THERAPY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-20",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "VESTAL",
        "authorized_official_first_name": "VICTORIA",
        "authorized_official_middle_name": "M.",
        "authorized_official_title_or_position": "OWNER  ADMINISTRATOR",
        "authorized_official_telephone_number": "360-642-8551",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "LPT"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "70644140",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Ilwaco, 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.