Marine View Physical Therapy, Inc

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

602252479 Issued in WA

Legal business name

MARINE VIEW PHYSICAL THERAPY, INC

Practice address

22007 Marine View Dr S Ste 203
Des Moines, WA 98198-6259

Phone

(206) 592-0568

Fax

(206) 592-0583

NPI assigned

Feb 8, 2007

Organization subpart

No

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

Authorized official

Name

Mr. Jerome Elliott Scanlon, P.T.

Title

Business Owner

Phone

(206) 592-0568

Specialties & licenses 1

Addresses

Other names 1

• Marine View Physical Therapy or MVPT, Inc Other name

Locations

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

{
    "created_epoch": "1170892800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1303948800000",
    "number": "1619018215",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22007 MARINE VIEW DR S STE 203",
            "city": "DES MOINES",
            "state": "WA",
            "postal_code": "981986259",
            "telephone_number": "206-592-0568",
            "fax_number": "206-592-0583"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22007 MARINE VIEW DR S STE 203",
            "city": "DES MOINES",
            "state": "WA",
            "postal_code": "981986259",
            "telephone_number": "206-592-0568",
            "fax_number": "206-592-0583"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARINE VIEW PHYSICAL THERAPY, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-08",
        "last_updated": "2011-04-28",
        "status": "A",
        "authorized_official_last_name": "SCANLON",
        "authorized_official_first_name": "JEROME",
        "authorized_official_middle_name": "ELLIOTT",
        "authorized_official_title_or_position": "BUSINESS OWNER",
        "authorized_official_telephone_number": "206-592-0568",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "P.T."
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Physical Therapist",
            "state": "WA",
            "license": "602252479",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Marine View Physical Therapy or MVPT, Inc",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 28, 2011; 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.