Spencer Matt, PT, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

61458829 Issued in WA

Practice address

451 Duvall Ave NE
Renton, WA 98059-4675

Phone

(425) 235-9505

NPI assigned

Jul 19, 2023

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in WA

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Peak Sports & Spine Physical Therapy-Renton, P.S.

  • Physical Therapist
  • Renton, WA
  • NPI 1841388618
  Medicare reassignment NPD

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

{
    "created_epoch": "1689724800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1689724800000",
    "number": "1457031023",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12736 NE 116TH LN APT L33",
            "city": "KIRKLAND",
            "state": "WA",
            "postal_code": "980348427",
            "telephone_number": "509-638-9328"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "451 DUVALL AVE NE",
            "city": "RENTON",
            "state": "WA",
            "postal_code": "980594675",
            "telephone_number": "425-235-9505"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MATT",
        "first_name": "SPENCER",
        "credential": "PT, DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-07-19",
        "last_updated": "2023-07-19",
        "certification_date": "2023-07-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "WA",
            "license": "61458829",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Bridgitte Camelia Mathiasen, LMHC, MSCC, BS
• Kara Lee Mathwich
• Meredith Elise Matsen, PHARMD
• Sharine Koyar Entice Matsunanga, BSN RN
• Shane-Ann Suehiro Matsunobu, PHARMD
• Leah Maughan, MA
• Gregory Maurer, MD
• Gina C Maurera
• Maxor National Pharmacy
• Maya Whole Health at Southport

• Physical Therapist in Renton, WA
• Providers in Renton, WA by specialty
• Physical Therapist in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 19, 2023; 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.