Charley Liu, PT, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

13873-24 Issued in WI

Practice address

37624 SE Fury St
Snoqualmie, WA 98065-9680

Phone

(425) 292-0223

NPI assigned

Jul 5, 2017

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Elite Physical Therapy

  dba Edge Phyiscal Therapy & Rehabilitation

  • Physical Therapist
  • Snoqualmie, WA
  • NPI 1154666154
  NPD

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

{
    "created_epoch": "1499212800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1542412800000",
    "number": "1548781131",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "550 OAKDALE AVE",
            "city": "GLENCOE",
            "state": "IL",
            "postal_code": "600222043",
            "telephone_number": "847-501-0192"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "37624 SE FURY ST",
            "city": "SNOQUALMIE",
            "state": "WA",
            "postal_code": "980659680",
            "telephone_number": "425-292-0223"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4602 Eastpark Blvd",
            "address_purpose": "LOCATION",
            "city": "Madison",
            "state": "WI",
            "postal_code": "537182002",
            "country_code": "US",
            "telephone_number": "608-440-6400",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LIU",
        "first_name": "CHARLEY",
        "credential": "PT, DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-07-05",
        "last_updated": "2018-11-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "WI",
            "license": "13873-24",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Elise Ann Leonti, PTA
• Susan K. Leveridge, MA, LMHC
• Emilia Lewis, PA-C
• Sijie Li
• Life Link Health Care Inc
• Veronica Lopez
• Susan Lord, COTA L
• Molly Ann Macdonald
• Anapurna Madrone, LMT
• Benjamin M Magoun, ND

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 17, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.