Individual provider Active NPI

Rebekah Elizabeth Hagen, DPT

  • Physical Therapist
  • Bonney Lake, WA
National Provider Identifier
1487819918
Registry record updated Jul 24, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT60022406 Issued in WA
Practice address
19820 Sr 410 E
Ste 201
Bonney Lake, WA 98391-6377
Phone
(253) 863-7510
Fax
(253) 863-5970
NPI assigned
Jul 24, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 24, 2008

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 PT60022406 WA Primary

Addresses

Primary practice location

19820 Sr 410 E
Ste 201
Bonney Lake, WA 98391-6377

Mailing address

PO Box 2170
Sumner, WA 98390-0480
Phone (253) 840-2313

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080811000098 WA Practitioner - Physical Therapist in Private Practice 1951475136 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2008
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

3929 Bridgeport Way W
Suite 208
University Place, WA 98466-4455

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PT60022406WAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Physiotherapy Associates, Inc. CurrentSince Dec 4, 2023 Accepting new patients
Physiotherapy Associates, Inc. Physical Therapist Current Accepting new patients
Physiotherapy Associates Inc CurrentSince Dec 4, 2023 Accepting new patients
Apple Physical Therapy LLC Physical Therapist Past Accepting new patients

Locations

463 Tremont St W
Ste 100
Port Orchard, WA 98366
Phone (360) 874-0745

23515 NE Novelty Hill Rd
Ste B213
Redmond, WA 98053
Phone (425) 868-5260

3929 Bridgeport Way W
Ste 208
University Place, WA 98466
Phone (253) 533-9023

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1216857600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1216857600000",
    "number": "1487819918",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2170",
            "city": "SUMNER",
            "state": "WA",
            "postal_code": "983900480",
            "telephone_number": "253-840-2313",
            "fax_number": "253-840-6340"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19820 SR 410 E",
            "address_2": "STE 201",
            "city": "BONNEY LAKE",
            "state": "WA",
            "postal_code": "983916377",
            "telephone_number": "253-863-7510",
            "fax_number": "253-863-5970"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAGEN",
        "first_name": "REBEKAH",
        "middle_name": "ELIZABETH",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-07-24",
        "last_updated": "2008-07-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "WA",
            "license": "PT60022406",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bonney Lake, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 24, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.