Olympic Sports and Spine Rehabilitation PS

Primary specialty

Physical TherapistTaxonomy code 225100000X

Legal business name

OLYMPIC SPORTS AND SPINE REHABILITATION PS

Practice address

8011 112TH Street CT E
Puyallup, WA 98373-7814

Phone

(253) 848-0662

Fax

(253) 848-8567

NPI assigned

May 9, 2006

Last updated

Feb 3, 2016By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mr. Vern J Essenberg Jr., PTNPI 1962458679

Title

Chief Operations Officer

Phone

(253) 581-5200

Specialties & licenses 4

Addresses

Other identifiers 7

Locations

Practitioners 41

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Vern J Essenberg Jr., MPT

  • Physical Therapist
  • University Place, WA
  • NPI 1962458679
  Authorized official Same address or phone
• Angela Ko, OT

  • Occupational Therapist
  • Tacoma, WA
  • NPI 1821648924
  NPD
• Amy Loi Luong, DPT

  • Physical Therapist
  • Tacoma, WA
  • NPI 1407491236
  NPD
• Nicholas Kaftan, PT

  • Physical Therapist
  • Colorado Springs, CO
  • NPI 1518513167
  NPD
• Katherine Jane Beaber, DPT

  • Physical Therapist
  • Tacoma, WA
  • NPI 1164074886
  NPD (past)
• Megan Alana Beltran, OTR/L

  • Occupational Therapist
  • Tacoma, WA
  • NPI 1770808677
  NPD (past)
• Noelle Christine Buell, BS,MS,PT

  • Physical Therapist
  • Puyallup, WA
  • NPI 1700823341
  NPD (past)
• Cheryl T Coddington, OTRL

  • Occupational Therapist
  • Lakewood, WA
  • NPI 1265488761
  NPD (past)
• Gary Joseph Dupuy Jr., DPT

  • Physical Therapist
  • University Place, WA
  • NPI 1669608527
  NPD (past)
• Melissa A Elsing, MPT, ATC

  • Athletic Trainer
  • Puyallup, WA
  • NPI 1952340556

  Physical Therapist

  NPD (past)
• Cathryn Elvins, OTR L

  • Occupational Therapist
  • Gig Harbor, WA
  • NPI 1376691592
  NPD (past)
• Kendra Guest, DPT

  • Physical Therapist
  • Tacoma, WA
  • NPI 1053890061
  NPD (past)

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

{
    "created_epoch": "1147132800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1454457600000",
    "number": "1558310375",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9315 GRAVELLY LAKE DR SW",
            "address_2": "SUITE 306",
            "city": "LAKEWOOD",
            "state": "WA",
            "postal_code": "984991574",
            "telephone_number": "253-581-5200",
            "fax_number": "253-581-5203"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8011 112TH STREET CT E",
            "city": "PUYALLUP",
            "state": "WA",
            "postal_code": "983737814",
            "telephone_number": "253-848-0662",
            "fax_number": "253-848-8567"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OLYMPIC SPORTS AND SPINE REHABILITATION PS",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-09",
        "last_updated": "2016-02-03",
        "status": "A",
        "authorized_official_last_name": "ESSENBERG",
        "authorized_official_first_name": "VERN",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "CHIEF OPERATIONS OFFICER",
        "authorized_official_telephone_number": "253-581-5200",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "PT"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7681703",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OWCP",
            "identifier": "192149400",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "CT1246",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LABOR & INDUSTRIES",
            "identifier": "42640",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "REGENCE BLUE SHIELD",
            "identifier": "PO9605",
            "state": "WA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7130271",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "L & I CRIME VICTIM PRGM",
            "identifier": "8930571",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jennifer Olson, URM
• Judy May Olson, RN
• Kelli Olson
• Sally Ann Olson, LMP
• Olympia Respiratory Services, LLC (AdaptHealth)
• Olympic Sports and Spine Rehabilitation, P.S.
• Rama R Omkaram
• Natasha Omura-Miller
• On Your Own Inc.
• Miroslava Anatolyevna Onishchenko

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 3, 2016; 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.