Active NPI
Candace S Ito, MPT
- Sports Physical Therapist
- Seattle, WA
National Provider Identifier
1447232970
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Sports Physical Therapist
- License
- PT00005995
- Practice address
- 11304 8TH Ave NE
Ste a
Seattle, WA 98125-6111 - Phone
- (206) 363-6184
- Fax
- (206) 363-6543
- NPI assigned
- Nov 18, 2005
- Last updated
- Jul 13, 2026
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | PT00005995 | WA | |
| Sports Physical Therapist | 2251S0007X | PT00005995 | WA | Primary |
Addresses
Primary practice location
11304 8TH Ave NE
Ste a
Seattle, WA 98125-6111
Mailing address
11304 8TH Ave NE
Ste a
Seattle, WA 98125-6111
Phone (206) 363-6184
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 57231T | Other | WA | REGENCE BLUE SHIELD |
| 0148998 | Other | WA | LABOR AND INDUSTRIES |
| 1910872 | Other | WA | FIRST HEALTH |
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PT00005995 | WA | MD | Sports Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Jet City Enterprists Inc | Physical Therapist | 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1132272000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1783900800000",
"number": "1447232970",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "11304 8TH AVE NE",
"address_2": "STE A",
"city": "SEATTLE",
"state": "WA",
"postal_code": "981256111",
"telephone_number": "206-363-6184",
"fax_number": "206-363-6543"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "11304 8TH AVE NE",
"address_2": "STE A",
"city": "SEATTLE",
"state": "WA",
"postal_code": "981256111",
"telephone_number": "206-363-6184",
"fax_number": "206-363-6543"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ITO",
"first_name": "CANDACE",
"middle_name": "S",
"credential": "MPT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2005-11-18",
"last_updated": "2026-07-13",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "WA",
"license": "PT00005995",
"primary": false
},
{
"code": "2251S0007X",
"taxonomy_group": "",
"desc": "Physical Therapist, Sports",
"state": "WA",
"license": "PT00005995",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "REGENCE BLUE SHIELD",
"identifier": "57231T",
"state": "WA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "LABOR AND INDUSTRIES",
"identifier": "0148998",
"state": "WA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "FIRST HEALTH",
"identifier": "1910872",
"state": "WA"
}
],
"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 13, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.