Active NPI
Tracy S Hartley, PT
- Physical Therapist
- Stanwood, WA
National Provider Identifier
1508803537
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- PT00005403
- Practice address
- 27500 102ND Ave NW
Ste 1
Stanwood, WA 98292-8092 - Phone
- (360) 629-7528
- Fax
- (360) 629-7632
- NPI assigned
- May 31, 2006
- Sex
- Male
- Sole proprietor
- No
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 | PT00005403 | WA | Primary |
Addresses
Primary practice location
27500 102ND Ave NW
Ste 1
Stanwood, WA 98292-8092
Mailing address
27500 102ND Ave NW
Ste 1
Stanwood, WA 98292-8092
Phone (360) 629-7528
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 |
|---|---|---|---|
| 5403 | WA | MD | Oral and Maxillofacial Surgery (Dentist) |
| PT00005403 | WA | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1149033600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1193702400000",
"number": "1508803537",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "27500 102ND AVE NW",
"address_2": "STE 1",
"city": "STANWOOD",
"state": "WA",
"postal_code": "982928092",
"telephone_number": "360-629-7528",
"fax_number": "360-629-7632"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "27500 102ND AVE NW",
"address_2": "STE 1",
"city": "STANWOOD",
"state": "WA",
"postal_code": "982928092",
"telephone_number": "360-629-7528",
"fax_number": "360-629-7632"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HARTLEY",
"first_name": "TRACY",
"middle_name": "S",
"credential": "PT",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-05-31",
"last_updated": "2007-10-30",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "WA",
"license": "PT00005403",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Stanwood, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 30, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.