NPIMap

Organization Active NPI

North Peninsula Physical Therapy, PLLC

  • Physical Therapy Clinic/Center
  • Poulsbo, WA
National Provider Identifier
1447718556
Registry record updated Mar 14, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy Clinic/CenterTaxonomy code 261QP2000X
Legal business name
NORTH PENINSULA PHYSICAL THERAPY, PLLC
Practice address
19980 10TH Ave NE Ste 201
Poulsbo, WA 98370-6322
Phone
(360) 598-1538
Fax
(360) 598-1541
NPI assigned
Mar 7, 2019
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 14, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Mieka Eisen
Title
Business Manager
Phone
(360) 528-3300

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Clinic/Center 261QP2000X Primary

Addresses

Primary practice location

19980 10TH Ave NE Ste 201
Poulsbo, WA 98370-6322

Mailing address

111 Tumwater Blvd SE Ste 113
Tumwater, WA 98501-6422
Phone (360) 528-3300

Other practice location 1

840 Madison Ave N Ste 102
Bainbridge Island, WA 98110-1769
Phone (206) 855-0955

Other names 1

  • DaVinci Physical Therapy Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20191002001524 WA Part B Supplier - Clinic/Group Practice 4284977489 Receives reassigned benefits from 8 practitioners
Practice locations: Bainbridge Island, WA; Poulsbo, WA

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 8

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1551916800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1741910400000",
    "number": "1447718556",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "111 TUMWATER BLVD SE STE 113",
            "city": "TUMWATER",
            "state": "WA",
            "postal_code": "985016422",
            "telephone_number": "360-528-3300",
            "fax_number": "360-528-8162"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19980 10TH AVE NE STE 201",
            "city": "POULSBO",
            "state": "WA",
            "postal_code": "983706322",
            "telephone_number": "360-598-1538",
            "fax_number": "360-598-1541"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "840 Madison Ave N Ste 102",
            "address_purpose": "LOCATION",
            "city": "Bainbridge Island",
            "state": "WA",
            "postal_code": "981101769",
            "country_code": "US",
            "telephone_number": "206-855-0955",
            "fax_number": "206-855-0801",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "NORTH PENINSULA PHYSICAL THERAPY, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-03-07",
        "last_updated": "2025-03-14",
        "certification_date": "2025-03-14",
        "status": "A",
        "authorized_official_last_name": "EISEN",
        "authorized_official_first_name": "MIEKA",
        "authorized_official_title_or_position": "BUSINESS MANAGER",
        "authorized_official_telephone_number": "360-528-3300"
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "DaVinci Physical Therapy",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "DaVinci Physical Therapy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Poulsbo, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 14, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.