Lake Forest Park Physical Therapy, PLLC

Primary specialty

Physical Therapy Clinic/CenterTaxonomy code 261QP2000X

License

PT00002011 Issued in WA

Legal business name

LAKE FOREST PARK PHYSICAL THERAPY, PLLC

Practice address

20011 Ballinger Way NE
Ste C100
Shoreline, WA 98155-1286

Phone

(206) 367-6069

Fax

(206) 367-6319

NPI assigned

Apr 1, 2009

Last updated

Apr 20, 2009By 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

Mrs. Robyn Namiko Whitehead, LPTA

Title

Executive Director

Phone

(206) 979-8248

Specialties & licenses 1

Addresses

Other identifiers 1

Practitioners 1

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.

• Loren L Johnson, PT

  • Physical Therapist
  • Arlington, WA
  • NPI 1518068774
  NPD (past)

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

{
    "created_epoch": "1238544000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1240185600000",
    "number": "1588806848",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20011 BALLINGER WAY NE",
            "address_2": "STE C100",
            "city": "SHORELINE",
            "state": "WA",
            "postal_code": "981551286",
            "telephone_number": "206-367-6069",
            "fax_number": "206-367-6319"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20011 BALLINGER WAY NE",
            "address_2": "STE C100",
            "city": "SHORELINE",
            "state": "WA",
            "postal_code": "981551286",
            "telephone_number": "206-367-6069",
            "fax_number": "206-367-6319"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LAKE FOREST PARK PHYSICAL THERAPY, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-04-01",
        "last_updated": "2009-04-20",
        "status": "A",
        "authorized_official_last_name": "WHITEHEAD",
        "authorized_official_first_name": "ROBYN",
        "authorized_official_middle_name": "NAMIKO",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "206-979-8248",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "LPTA"
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": "WA",
            "license": "PT00002011",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8371353",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Anthony Gerard L'Esperance, PHARMD
• Amanda Laban
• Rachel C Lagrange, OT
• Trifenia Laguio
• Lake City Partners Ending Homelessness
• Lake Washington Healthcare, Inc. (Shoreline Health and Rehabilitation)
• Joanne S Lam, MSW
• Katelin Storm Lambert, PHARMD
• Robert W Landerholm, MD
• Devin Langaker, DPT

• Physical Therapy Clinic/Center in Shoreline, WA
• Providers in Shoreline, WA by specialty
• Physical Therapy Clinic/Center in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 20, 2009; 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.