Individual provider Active NPI

Will Thomas Lawrence, DPT

  • Physical Therapist
  • Vancouver, WA
National Provider Identifier
1366096489
Registry record updated Jul 26, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT60979089 Issued in WA
Practice address
2415 NE 134TH St Ste 201
Vancouver, WA 98686-3032
Phone
(360) 859-3346
Fax
(360) 859-3357
NPI assigned
Jul 26, 2019
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 26, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X PT60979089 WA Primary

Addresses

Primary practice location

2415 NE 134TH St Ste 201
Vancouver, WA 98686-3032

Mailing address

1480 NE Village St
Fairview, OR 97024-3827
Phone (503) 489-1174

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220104001433 OR Practitioner - Physical Therapist in Private Practice 3971834706 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Therapydia IncGroup PAC ID 2264678226, 35 clinicians

Practice addresses (Care Compare)

3925 SW 153Rd Dr
Suite 210
Beaverton, OR 97003-4176
Phone (971) 727-8155

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PT60979089WAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Therapydia, Inc. Physical Therapist CurrentSince Jan 29, 2024 Accepting new patients
Proactive Orthopedic and Sports Physical Therapy of Battle Ground CurrentSince Aug 6, 2019 Accepting new patients
Big Sky Physical Therapy Physical Therapist CurrentSince Nov 1, 2021 Accepting new patients
Therapydia, Inc. Physical Therapist CurrentSince Jan 29, 2024 Accepting new patients

Locations

3925 SW 153rd Dr
Ste 210
Beaverton, OR 97003
Phone (503) 644-0600

1480 NE Village St
Fairview, OR 97024
Phone (503) 489-1174

609 NE Baker St
Ste 140
McMinnville, OR 97128
Phone (503) 472-0848

2808 E Burnside St
Portland, OR 97214
Phone (503) 477-4802

1808 SW 9th Ave
Ste 101
Battle Ground, WA 98604
Phone (360) 723-0797

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1564099200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1564099200000",
    "number": "1366096489",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1480 NE VILLAGE ST",
            "city": "FAIRVIEW",
            "state": "OR",
            "postal_code": "970243827",
            "telephone_number": "503-489-1174",
            "fax_number": "503-489-1650"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2415 NE 134TH ST STE 201",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986863032",
            "telephone_number": "360-859-3346",
            "fax_number": "360-859-3357"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LAWRENCE",
        "first_name": "WILL",
        "middle_name": "THOMAS",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-07-26",
        "last_updated": "2019-07-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "WA",
            "license": "PT60979089",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Vancouver, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 26, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.