Individual provider Active NPI

Amanda Martin

  • Physical Therapist
  • Olympia, WA
National Provider Identifier
1417757469
Registry record updated Mar 18, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
60089323 Issued in WA
Practice address
4632 Beverly Dr NE
Olympia, WA 98516-2291
Phone
(410) 746-9525
NPI assigned
Mar 18, 2025
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 18, 2025

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 60089323 WA Primary

Addresses

Primary practice location

4632 Beverly Dr NE
Olympia, WA 98516-2291

Mailing address

4632 Beverly Dr NE
Olympia, WA 98516-2291

Other names 1

  • Amanda Jones Other name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250328002544 WA Practitioner - Physical Therapist in Private Practice 4688197734 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Washington Luna Care Physical Therapy LLCGroup PAC ID 7416283817, 161 clinicians
Physical Therapy Empowered PLLCGroup PAC ID 7012347388, 4 clinicians

Practice addresses (Care Compare)

Bellevue, WA 98006
Phone (866) 525-3175

6307 Rich Rd SE
Olympia, WA 98501-5317
Phone (360) 587-0686

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Swedish Health Services CurrentSince Jun 9, 2025 Accepting new patients
King County Public Hospital District No 2 Current Accepting new patients
King County Public Hospital District No. 2 Physical Therapist CurrentSince Mar 20, 2025 Accepting new patients
Swedish Health Services Physical Therapist CurrentSince Jun 9, 2025 Accepting new patients
Washington Luna Care Physical Therapy LLC Physical Therapist CurrentSince Mar 20, 2025 Accepting new patients

Locations

13555 SE 36th St
Ste 100
Bellevue, WA 98006

13020 Meridian Ave S
Everett, WA 98208
Phone (425) 357-3700

12040 NE 128th St
#10
Kirkland, WA 98034
Phone (206) 466-0369

800 5th Ave
Ste P100
Seattle, WA 98104
Phone (206) 320-2700

2450 33rd Ave W
Ste 100
Seattle, WA 98199
Phone (206) 320-3364

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": "1742256000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1742256000000",
    "number": "1417757469",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4632 BEVERLY DR NE",
            "city": "OLYMPIA",
            "state": "WA",
            "postal_code": "985162291"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4632 BEVERLY DR NE",
            "city": "OLYMPIA",
            "state": "WA",
            "postal_code": "985162291",
            "telephone_number": "410-746-9525"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARTIN",
        "first_name": "AMANDA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2025-03-18",
        "last_updated": "2025-03-18",
        "certification_date": "2025-03-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "WA",
            "license": "60089323",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "AMANDA",
            "last_name": "JONES",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Olympia, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 18, 2025; 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.