Active NPI
Patrice Dodge, PHYSICAL THERAPY
- Physical Therapist
- Bremerton, WA
National Provider Identifier
1508286402
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 000002990
- Practice address
- 7139 Provost Rd NW
Bremerton, WA 98312-1195 - Phone
- (360) 434-2951
- NPI assigned
- Apr 18, 2014
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 000002990 | WA | Primary |
Addresses
Primary practice location
7139 Provost Rd NW
Bremerton, WA 98312-1195
Mailing address
7139 Provost Rd NW
Bremerton, WA 98312-1195
Phone (360) 434-2951
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 000002990 | WA | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1397779200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1397779200000",
"number": "1508286402",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7139 PROVOST RD NW",
"city": "BREMERTON",
"state": "WA",
"postal_code": "983121195",
"telephone_number": "360-434-2951"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "7139 PROVOST RD NW",
"city": "BREMERTON",
"state": "WA",
"postal_code": "983121195",
"telephone_number": "360-434-2951"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DODGE",
"first_name": "PATRICE",
"name_prefix": "Mrs.",
"credential": "PHYSICAL THERAPY",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2014-04-18",
"last_updated": "2014-04-18",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "WA",
"license": "000002990",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Bremerton, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 18, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.