Individual provider Active NPI

Michelle Berman

  • Physical Therapist
  • Vancouver, WA
National Provider Identifier
1417503574
Registry record updated Jun 25, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Practice address
717 Grand Blvd
Vancouver, WA 98661-4821
Phone
(360) 258-1637
Fax
(360) 314-2627
NPI assigned
Aug 14, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 25, 2026

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 Primary

Addresses

Primary practice location

717 Grand Blvd
Vancouver, WA 98661-4821

Mailing address

717 Grand Blvd
Vancouver, WA 98661-4821
Phone (360) 258-1637

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20211012001399 WA Practitioner - Physical Therapist in Private Practice 9335547983 Reassigns benefits to 3 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
Boomerang Physical TherapyGroup PAC ID 2163725847, 2 clinicians

Practice addresses (Care Compare)

717 Grand Blvd
Vancouver, WA 98661-4821
Phone (360) 258-1637

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as apm

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Multicare Health System CurrentSince Oct 25, 2024 Accepting new patients
Boomerang Physical Therapy CurrentSince May 12, 2025 Accepting new patients
Apple Physical Therapy, LLC Physical Therapist CurrentSince Oct 18, 2021 Accepting new patients
Apple Physical Therapy LLC Physical Therapist CurrentSince Oct 18, 2021 Accepting new patients
Multicare Health System Current Accepting new patients
Multicare Health System CurrentSince Oct 25, 2024 Accepting new patients

Locations

4947 Paysphere Cir
Chicago, IL 60674
Phone (630) 783-2001

15600 NE 8th St
Ste E6
Bellevue, WA 98008
Phone (425) 214-7679

10004 204th Ave E
Ste 3100
Bonney Lake, WA 98391
Phone (253) 863-7510

20821 Sr 410 E
Bonney Lake, WA 98391
Phone (253) 863-7510

4220 Hoyt Ave
Everett, WA 98203
Phone (425) 258-5330

32030 23rd Ave S
Federal Way, WA 98003
Phone (253) 946-4852

4700 Point Fosdick Dr
Ste 104
Gig Harbor, WA 98335
Phone (253) 459-7590

222 State Ave N
Kent, WA 98030
Phone (253) 372-7680

130 Marvin Rd SE
Ste 203
Lacey, WA 98503
Phone (360) 456-3300

717 Grand Blvd
Vancouver, WA 98661
Phone (360) 258-1637

4201 NE 66th Ave
Ste 104
Vancouver, WA 98661
Phone (360) 254-4914

Organizations & group practices 6

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": "1565740800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1782345600000",
    "number": "1417503574",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "717 GRAND BLVD",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986614821",
            "telephone_number": "360-258-1637",
            "fax_number": "360-314-2627"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "717 GRAND BLVD",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986614821",
            "telephone_number": "360-258-1637",
            "fax_number": "360-314-2627"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BERMAN",
        "first_name": "MICHELLE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-08-14",
        "last_updated": "2026-06-25",
        "certification_date": "2026-06-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "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 Jun 25, 2026; 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.