Columbia Physical Therapy Services, Inc,

Primary specialty

Physical Therapy Clinic/CenterTaxonomy code 261QP2000X

License

PT00002391 Issued in WA

Legal business name

COLUMBIA PHYSICAL THERAPY SERVICES, INC,

Practice address

3207 Rainier Ave S
Seattle, WA 98144-6031

Phone

(206) 722-2205

Fax

(206) 722-5457

NPI assigned

Aug 5, 2007

Organization subpart

Yes

Parent organization

COLUMBIA PHYSICAL THERAPY SERVICES, INC,As reported in NPPES

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

Authorized official

Name

Mr. Bruce Gary Clayton, PHYSICAL THERAPISTNPI 1770684698

Title

Physical Therapist

Phone

(206) 722-2205

Specialties & licenses 2

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Enrolled in WA

Enrollment records 1

Part of

Columbia P T SVCS Inc

Locations

Practitioners 1

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

• Bruce Gary Clayton

  • Physical Therapist
  • Seattle, WA
  • NPI 1770684698
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1186272000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1412640000000",
    "number": "1457542466",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3207 RAINIER AVE S",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981446031",
            "telephone_number": "206-722-2205",
            "fax_number": "206-722-5457"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3207 RAINIER AVE S",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981446031",
            "telephone_number": "206-722-2205",
            "fax_number": "206-722-5457"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COLUMBIA PHYSICAL THERAPY SERVICES, INC,",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "COLUMBIA PHYSICAL THERAPY SERVICES, INC,",
        "enumeration_date": "2007-08-05",
        "last_updated": "2014-10-07",
        "status": "A",
        "authorized_official_last_name": "CLAYTON",
        "authorized_official_first_name": "BRUCE",
        "authorized_official_middle_name": "GARY",
        "authorized_official_title_or_position": "PHYSICAL THERAPIST",
        "authorized_official_telephone_number": "206-722-2205",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "PHYSICAL THERAPIST"
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": "WA",
            "license": "PT00002391",
            "primary": true
        },
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": "WA",
            "license": "PT00002400",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WASHINGTON STATE CRIME VI",
            "identifier": "8918108",
            "state": "WA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7004690",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WA STATE LABOR & INDUSTRI",
            "identifier": "0072973",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Marc Dante Coltrera, M.D.
• Columbia Basin Imaging PC
• Columbia Chiropractic PLLC
• Columbia City Dental
• Columbia Lutheran Ministries
• Roy Mitchell Colven, M.D.
• Lucy Anne Colville, MD
• David Alexander Colvin, MD
• Mai Otsuka Colvin, M.D.
• Marielle Christina-Slothouber Colvin, MSN, FNP-C

• Physical Therapy Clinic/Center in Seattle, WA
• Providers in Seattle, WA by specialty
• Physical Therapy Clinic/Center in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 7, 2014; 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.