Individual provider Active NPI

Robyn Peterson

  • Physical Therapist
  • Everett, WA
National Provider Identifier
1497187892
Registry record updated Nov 21, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT60280490 Issued in WA
Practice address
3927 Rucker Ave
Everett, WA 98201-4833
Phone
(425) 339-5419
NPI assigned
Aug 7, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 21, 2014

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 PT60280490 WA Primary

Addresses

Primary practice location

3927 Rucker Ave
Everett, WA 98201-4833

Mailing address

PO Box 5127
Everett, WA 98206-5127

Other identifiers 1

IdentifierTypeStateIssuer
2032507MedicaidWA

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20140415002113 WA Practitioner - Physical Therapist in Private Practice 6103058672 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

12040 NE 128TH St
Kirkland, WA 98034-3013
Phone (425) 899-2560

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Overlake Medical Clinics, LLC CurrentSince Nov 16, 2013 Accepting new patients
Overlake Medical Clinics LLC CurrentSince Nov 16, 2013 Accepting new patients
Washington Luna Care Physical Therapy LLC Physical Therapist CurrentSince Dec 19, 2025 Accepting new patients
Swedish Health Services Physical Therapist CurrentSince Feb 23, 2026 Accepting new patients
King County Public Hospital District No. 2 Physical Therapist CurrentSince Dec 19, 2025 Accepting new patients
Swedish Health Services CurrentSince Feb 23, 2026 Accepting new patients

Locations

13555 SE 36th St
Ste 100
Bellevue, WA 98006

1417 116th Ave NE
Ste 110
Bellevue, WA 98004
Phone (425) 688-5700

1750 112th Ave NE
Ste B102
Bellevue, WA 98004
Phone (425) 688-5460

12040 NE 128th St
Kirkland, WA 98034
Phone (425) 899-1000

12040 NE 128th St
#10
Kirkland, WA 98034
Phone (206) 466-0369

800 5th Ave
Ste P100
Seattle, WA 98104
Phone (206) 320-2700

Organizations & group practices 7

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": "1375833600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1416528000000",
    "number": "1497187892",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 5127",
            "city": "EVERETT",
            "state": "WA",
            "postal_code": "982065127"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3927 RUCKER AVE",
            "city": "EVERETT",
            "state": "WA",
            "postal_code": "982014833",
            "telephone_number": "425-339-5419"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETERSON",
        "first_name": "ROBYN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-08-07",
        "last_updated": "2014-11-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "WA",
            "license": "PT60280490",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2032507",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Everett, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 21, 2014; 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.