Ravenna Physical Therapy LLC

Primary specialty

Physical Therapy Clinic/CenterTaxonomy code 261QP2000X

License

PT00009881 Issued in WA

Legal business name

RAVENNA PHYSICAL THERAPY LLC

Practice address

2612 3Rd Ave
Seattle, WA 98121-1214

Phone

(206) 686-4073

Fax

(206) 260-4565

NPI assigned

Jun 23, 2015

Organization subpart

No

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

Authorized official

Name

Laura Bannister, DPTNPI 1083698070

Title

Owner/Physical Therapist

Phone

(206) 686-4073

Specialties & licenses 1

Addresses

Other names 1

• Avant Physical Therapy Doing business as

Locations

Practitioners 2

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

• Laura Bannister, DPT

  • Physical Therapist
  • Seattle, WA
  • NPI 1083698070
  NPD (past) Authorized official
• Katie Okun, DPT

  • Physical Therapist
  • Seattle, WA
  • NPI 1174977532
  NPD (past)

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

{
    "created_epoch": "1435017600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1435017600000",
    "number": "1467834762",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2612 3RD AVE",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981211214",
            "telephone_number": "206-686-4073",
            "fax_number": "206-260-4565"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2612 3RD AVE",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981211214",
            "telephone_number": "206-686-4073",
            "fax_number": "206-260-4565"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RAVENNA PHYSICAL THERAPY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-06-23",
        "last_updated": "2015-06-23",
        "status": "A",
        "authorized_official_last_name": "BANNISTER",
        "authorized_official_first_name": "LAURA",
        "authorized_official_title_or_position": "OWNER/PHYSICAL THERAPIST",
        "authorized_official_telephone_number": "206-686-4073",
        "authorized_official_credential": "DPT"
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": "WA",
            "license": "PT00009881",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Avant Physical Therapy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Ali Cyrus Ravanpay
• Lelach Rave, M.D.
• Harmony Raveler, LMFTA
• Raven Natural Health PLLC
• Ravenna Center for Neuropsychiatry, PLLC
• Lindsay Jean Ravensong, LMP
• Megan Raventos, 101Y00000X
• Raelyn Marie Raver, CRNA
• Shruthi Ravi
• Li Ravicz, PH.D.

• 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 Jun 23, 2015; 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.