Individual provider Active NPI

Lance M Miller, PT

  • Physical Therapist
  • Everett, WA
National Provider Identifier
1447292453
Registry record updated Sep 17, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Practice address
1502 Hewitt Ave
Everett, WA 98201-3504
Phone
(425) 512-8695
Fax
(425) 512-8697
NPI assigned
Jun 12, 2006
Last updated
Sep 17, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 17, 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

1502 Hewitt Ave
Everett, WA 98201-3504

Mailing address

1502 Hewitt Ave
Everett, WA 98201-3504
Phone (425) 512-8695

Other practice location 1

2205 Wall St
Everett, WA 98201-3761
Phone (425) 512-8695

Other identifiers 7

IdentifierTypeStateIssuer
8931866OtherWAL&I CRIME VICTIMS
P00034707OtherWARAILROAD MEDICARE
7930039OtherWAAETNA
8335895MedicaidWA
0223987OtherWADEPT. OF LABOR & INDUSTRY
4788MIOtherWAREGENCE BLUE SHIELD
470930529-98201-A013OtherWATRICARE

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

Practice roles

OrganizationSpecialtyStatusNew patients
Engineered Sports 2 PLLC Physical Therapist CurrentSince Sep 30, 2022 Accepting new patients
Integrated Rehabilitation Group, PC Physical Therapist Past Accepting new patients

Locations

2205 Wall St
Everett, WA 98201
Phone (425) 512-8695

Organizations & group practices 2

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": "1150070400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1789603200000",
    "number": "1447292453",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1502 HEWITT AVE",
            "city": "EVERETT",
            "state": "WA",
            "postal_code": "982013504",
            "telephone_number": "425-512-8695",
            "fax_number": "425-512-8697"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1502 HEWITT AVE",
            "city": "EVERETT",
            "state": "WA",
            "postal_code": "982013504",
            "telephone_number": "425-512-8695",
            "fax_number": "425-512-8697"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2205 Wall St",
            "address_purpose": "LOCATION",
            "city": "Everett",
            "state": "WA",
            "postal_code": "982013761",
            "country_code": "US",
            "telephone_number": "425-512-8695",
            "fax_number": "425-512-8697",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MILLER",
        "first_name": "LANCE",
        "middle_name": "M",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-12",
        "last_updated": "2026-09-17",
        "certification_date": "2026-09-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "L&I CRIME VICTIMS",
            "identifier": "8931866",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00034707",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "7930039",
            "state": "WA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8335895",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DEPT. OF LABOR & INDUSTRY",
            "identifier": "0223987",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "REGENCE BLUE SHIELD",
            "identifier": "4788MI",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TRICARE",
            "identifier": "470930529-98201-A013",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Everett, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 17, 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.

Verify at the official NPI Registry.