Active NPI
Gwen M Gentes, PTA
- Physical Therapy Assistant
- Mountlake Terrace, WA
National Provider Identifier
1386864270
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapy Assistant
- License
- 308-019
- Practice address
- Ballinger Rehabilitation and Therapy
6007 B 244TH St SW
Mountlake Terrace, WA 98043 - Phone
- (425) 640-4762
- Fax
- (425) 640-4885
- NPI assigned
- Apr 26, 2007
- 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 Therapy Assistant | 225200000X | 308-019 | WI | Primary |
Addresses
Primary practice location
Ballinger Rehabilitation and Therapy
6007 B 244TH St SW
Mountlake Terrace, WA 98043
Mailing address
6110 61St Ave SE Apt a
Snohomish, WA 98290-5124
Phone (608) 769-9778
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 308-019 | WI | MD | Physical Therapy Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1177545600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1386864270",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6110 61ST AVE SE APT A",
"city": "SNOHOMISH",
"state": "WA",
"postal_code": "982905124",
"telephone_number": "608-769-9778"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "BALLINGER REHABILITATION AND THERAPY",
"address_2": "6007 B 244TH ST SW",
"city": "MOUNTLAKE TERRACE",
"state": "WA",
"postal_code": "98043",
"telephone_number": "425-640-4762",
"fax_number": "425-640-4885"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GENTES",
"first_name": "GWEN",
"middle_name": "M",
"name_prefix": "Ms.",
"credential": "PTA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-04-26",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "225200000X",
"taxonomy_group": "",
"desc": "Physical Therapy Assistant",
"state": "WI",
"license": "308-019",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Mountlake Terrace, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.