Individual provider Active NPI

Tara E Socquet, PT

  • Physical Therapist
  • Vancouver, WA
National Provider Identifier
1457408098
Registry record updated Apr 15, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT60025787 Issued in WA
Practice address
8716 E Mill Plain Blvd
Vancouver, WA 98664-2531
Phone
(360) 696-5300
Fax
(360) 729-3372
NPI assigned
Jan 5, 2007
Last updated
Apr 15, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 15, 2024

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 PT60025787 WA Primary

Addresses

Primary practice location

8716 E Mill Plain Blvd
Vancouver, WA 98664-2531

Mailing address

2515 NW 47TH Ave
Camas, WA 98607-8314
Phone (650) 814-9868

Other identifiers 1

IdentifierTypeStateIssuer
PT60025787OtherWAPT LICENSE

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080708000531 WA Practitioner - Physical Therapist in Private Practice 4284733197 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Joint Ventures Therapeutics, PC Current Accepting new patients
BDB Rehabilitation PC Physical Therapist CurrentSince May 6, 2024 Accepting new patients
Joint Ventures Therapeutics PC Physical Therapist CurrentSince Jun 16, 2008 Accepting new patients
BDB Rehabilitation PC Physical Therapist CurrentSince May 6, 2024 Accepting new patients

Locations

4933 Old Greenwood Rd
Fort Smith, AR 72903

16111 SE McGillivray Blvd
Ste A
Vancouver, WA 98683
Phone (360) 253-4020

16219 SE 12th St
Ste 100
Vancouver, WA 98683
Phone (360) 253-4020

Organizations & group practices 5

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": "1167955200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1713139200000",
    "number": "1457408098",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2515 NW 47TH AVE",
            "city": "CAMAS",
            "state": "WA",
            "postal_code": "986078314",
            "telephone_number": "650-814-9868"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8716 E MILL PLAIN BLVD",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986642531",
            "telephone_number": "360-696-5300",
            "fax_number": "360-729-3372"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SOCQUET",
        "first_name": "TARA",
        "middle_name": "E",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-05",
        "last_updated": "2024-04-15",
        "certification_date": "2024-04-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "WA",
            "license": "PT60025787",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PT LICENSE",
            "identifier": "PT60025787",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Vancouver, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 15, 2024; 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.