NPIMap

Organization Active NPI

Therapeutic Associates Inc

Doing business as TAI Canyon Park Sport & Spine Physical Therapy

  • Physical Therapist
  • Bothell, WA
National Provider Identifier
1558347302
Registry record updated May 23, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Legal business name
THERAPEUTIC ASSOCIATES INC
Doing business as
TAI Canyon Park Sport & Spine Physical Therapy
Practice address
19017 120TH Ave NE BLDG 1
Suite 111
Bothell, WA 98011-9510
Phone
(425) 489-3420
Fax
(425) 489-3421
NPI assigned
Dec 22, 2005
Last updated
May 23, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 23, 2023

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

Authorized official

Name
Melissa Hamilton
Title
Dir Payer & Provider Relations
Phone
(503) 443-6156

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X WA Primary

Addresses

Primary practice location

19017 120TH Ave NE BLDG 1
Suite 111
Bothell, WA 98011-9510

Mailing address

16083 SW Upper Boones Ferry Rd
Suite 300
Tigard, OR 97224-7736
Phone (800) 219-8835

Other names 1

  • TAI Canyon Park Sport & Spine Physical Therapy Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA, OR2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20040126000117 WA Part B Supplier - Clinic/Group Practice 0042116279 Receives reassigned benefits from 127 practitioners
38 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Seattle, WA; Selah, WA; Shoreline, WA; Spokane, WA; Liberty Lake, WA; Spokane Valley, WA; Tacoma, WA; University Place, WA…
O20040205000432 OR Part B Supplier - Clinic/Group Practice 0042116279 Receives reassigned benefits from 305 practitioners
This NPI is an additional NPI on the enrollment

Other NPIs on the same Medicare enrollment 38

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

View all 38

National Provider Directory

National Provider Directory
Tax ID family
Port Townsend Physical100 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 24

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 24

Practitioners & affiliated clinicians

Practitioners 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1135209600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1684800000000",
    "number": "1558347302",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16083 SW UPPER BOONES FERRY RD",
            "address_2": "SUITE 300",
            "city": "TIGARD",
            "state": "OR",
            "postal_code": "972247736",
            "telephone_number": "800-219-8835",
            "fax_number": "503-443-1402"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19017 120TH AVE NE BLDG 1",
            "address_2": "SUITE 111",
            "city": "BOTHELL",
            "state": "WA",
            "postal_code": "980119510",
            "telephone_number": "425-489-3420",
            "fax_number": "425-489-3421"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THERAPEUTIC ASSOCIATES INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-12-22",
        "last_updated": "2023-05-23",
        "certification_date": "2023-05-23",
        "status": "A",
        "authorized_official_last_name": "HAMILTON",
        "authorized_official_first_name": "MELISSA",
        "authorized_official_title_or_position": "DIR PAYER & PROVIDER RELATIONS",
        "authorized_official_telephone_number": "503-443-6156"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "WA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "TAI Canyon Park Sport & Spine Physical Therapy",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "TAI Canyon Park Sport & Spine Physical Therapy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Bothell, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 23, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.