NPIMap

Organization Active NPI

Pullman Sports Physical Therapy, Inc

  • Physical Therapist
  • Pullman, WA
National Provider Identifier
1366508087
Registry record updated Apr 12, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT00003333 Issued in WA
Legal business name
PULLMAN SPORTS PHYSICAL THERAPY, INC
Practice address
588 SE Bishop Blvd
Suite a
Pullman, WA 99163-5534
Phone
(509) 332-7778
Fax
(509) 332-7032
NPI assigned
Dec 28, 2006
Last updated
Apr 12, 2012By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 12, 2012

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

Authorized official

Name
Brenda Rose Cleven
Title
Office Manager
Phone
(509) 332-7778

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X PT00003333 WA Primary

Addresses

Primary practice location

588 SE Bishop Blvd
Suite a
Pullman, WA 99163-5534

Mailing address

588 SE Bishop Blvd
Suite a
Pullman, WA 99163-5534
Phone (509) 332-7778

National Provider Directory

National Provider Directory

Locations

588 SE Bishop Blvd
Ste A
Pullman, WA 99163
Phone (509) 332-7778

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1167264000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1334188800000",
    "number": "1366508087",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "588 SE BISHOP BLVD",
            "address_2": "SUITE A",
            "city": "PULLMAN",
            "state": "WA",
            "postal_code": "991635534",
            "telephone_number": "509-332-7778",
            "fax_number": "509-332-7032"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "588 SE BISHOP BLVD",
            "address_2": "SUITE A",
            "city": "PULLMAN",
            "state": "WA",
            "postal_code": "991635534",
            "telephone_number": "509-332-7778",
            "fax_number": "509-332-7032"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PULLMAN SPORTS PHYSICAL THERAPY, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-28",
        "last_updated": "2012-04-12",
        "status": "A",
        "authorized_official_last_name": "CLEVEN",
        "authorized_official_first_name": "BRENDA",
        "authorized_official_middle_name": "ROSE",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "509-332-7778"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "WA",
            "license": "PT00003333",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pullman, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 12, 2012; 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.