Walla Walla Physical Therapy Center Aps

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

601 755 670 Issued in WA

Legal business name

WALLA WALLA PHYSICAL THERAPY CENTER APS

Practice address

275 W Tietan St
Walla Walla, WA 99362-4363

Phone

(509) 522-0114

Fax

(509) 522-9868

NPI assigned

Jul 22, 2006

Reactivated

Jun 22, 2023

Last updated

Jun 22, 2023By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Michael J Clark, PTNPI 1306849955

Title

Physical Therapist/Owner

Phone

(509) 522-0114

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in WA

Enrollment records 1

Practitioners 14

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Michael J Clark, PT

  • Physical Therapist
  • Walla Walla, WA
  • NPI 1306849955
  Medicare reassignment Care Compare group Authorized official
• Mitchell James Lesmeister, PT, DPT

  • Physical Therapist
  • Walla Walla, WA
  • NPI 1154162345
  Medicare reassignment Care Compare group NPD
• Andrea Giedeman, MSPT

  • Physical Therapist
  • Walla Walla, WA
  • NPI 1326345208
  Medicare reassignment Care Compare group
• George A Arias, M.S.P.T.

  • Physical Therapist
  • Walla Walla, WA
  • NPI 1407820103
  NPD
• Kelly Maher

  • Physical Therapist
  • Walla Walla, WA
  • NPI 1275145179
  NPD
• Tamara Nicole Patrick, PT,DPT

  • Physical Therapist
  • Walla Walla, WA
  • NPI 1942713029
  NPD
• Brooke Lynn Royse

  • Physical Therapist
  • Walla Walla, WA
  • NPI 1861327249
  NPD
• Tyler J Smith, PTA

  • Physical Therapist
  • Spokane, WA
  • NPI 1144789793
  NPD
• Dave Paul Barcenas, MSPT

  • Physical Therapist
  • Walla Walla, WA
  • NPI 1063431864
  NPD (past)
• Jennifer Patricia Caso, ARNP

  • Registered Nurse
  • Walla Walla, WA
  • NPI 1396744322
  NPD (past)
• Troy Hodges, PTA

  • Physical Therapy Assistant
  • Walla Walla, WA
  • NPI 1306146428
  NPD (past)
• Melissa E Peterson

  • Physical Therapist
  • Centralia, WA
  • NPI 1538228051
  NPD (past)

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

{
    "created_epoch": "1153526400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1687392000000",
    "number": "1477574606",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "275 W TIETAN ST",
            "city": "WALLA WALLA",
            "state": "WA",
            "postal_code": "993624363",
            "telephone_number": "509-522-0114",
            "fax_number": "509-522-9868"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "275 W TIETAN ST",
            "city": "WALLA WALLA",
            "state": "WA",
            "postal_code": "993624363",
            "telephone_number": "509-522-0114",
            "fax_number": "509-522-9868"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WALLA WALLA PHYSICAL THERAPY CENTER APS",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-22",
        "last_updated": "2023-06-22",
        "certification_date": "2023-06-22",
        "deactivation_date": "2023-06-02",
        "reactivation_date": "2023-06-22",
        "status": "A",
        "authorized_official_last_name": "CLARK",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "PHYSICAL THERAPIST/OWNER",
        "authorized_official_telephone_number": "509-522-0114",
        "authorized_official_credential": "PT"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist",
            "state": "WA",
            "license": "601 755 670",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Walla Walla Homemedical Inc
• Walla Walla Naturopathic PLLC (Melissa McClintock)
• Walla Walla Oms, LLC
• Walla Walla Orthodontics
• Walla Walla Pediatric Dentistry
• Walla Walla Public Schools
• Walla Walla Senior Citizens Center Inc (The Center at the Park)
• Walla Walla Therapy LLC
• Walla Walla Vamc
• Walla Walla Vamc

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 22, 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.