Individual provider Active NPI

Brenda Jean Matter, PHYSICAL THERAPIST

  • Physical Therapist
  • Seattle, WA
National Provider Identifier
1417028176
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT00002707 Issued in WA
Practice address
3823 Delridge Way SW
Seattle, WA 98106-1133
Phone
(206) 301-0600
Fax
(206) 301-0601
NPI assigned
Nov 13, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 PT00002707 WA Primary

Addresses

Primary practice location

3823 Delridge Way SW
Seattle, WA 98106-1133

Mailing address

3953 S Ferdinand St
Seattle, WA 98118-1739
Phone (206) 725-8366

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

LicenseStateTypeSpecialty
PT00002707WAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Sound Physical Therapy Past Accepting new patients

Organizations & group practices 1

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": "1163376000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1417028176",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3953 S FERDINAND ST",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981181739",
            "telephone_number": "206-725-8366",
            "fax_number": "206-301-0601"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3823 DELRIDGE WAY SW",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981061133",
            "telephone_number": "206-301-0600",
            "fax_number": "206-301-0601"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MATTER",
        "first_name": "BRENDA",
        "middle_name": "JEAN",
        "name_prefix": "Ms.",
        "credential": "PHYSICAL THERAPIST",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-13",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "WA",
            "license": "PT00002707",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Seattle, 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.

Verify at the official NPI Registry.