Medical Center Physical Therapy & Sports Rehab Inc PS

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

PT00000697 Issued in WA

Legal business name

MEDICAL CENTER PHYSICAL THERAPY & SPORTS REHAB INC PS

Practice address

307 S 12TH Ave Ste 5
Yakima, WA 98902-3139

Phone

(509) 453-3103

Fax

(509) 453-2057

NPI assigned

Jul 19, 2007

Organization subpart

No

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

Authorized official

Name

Steven E Dale, PTNPI 1477632412

Title

Owner

Phone

(509) 453-3103

Specialties & licenses 1

Addresses

Other identifiers 2

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Steven Eugene Dale, PT

  • Physical Therapist
  • Yakima, WA
  • NPI 1477632412
  NPD (past) Authorized official

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

{
    "created_epoch": "1184803200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1195171200000",
    "number": "1649470501",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "307 S 12TH AVE STE 5",
            "city": "YAKIMA",
            "state": "WA",
            "postal_code": "989023139",
            "telephone_number": "509-453-3103",
            "fax_number": "509-453-2057"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "307 S 12TH AVE STE 5",
            "city": "YAKIMA",
            "state": "WA",
            "postal_code": "989023139",
            "telephone_number": "509-453-3103",
            "fax_number": "509-453-2057"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEDICAL CENTER PHYSICAL THERAPY & SPORTS REHAB INC PS",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-07-19",
        "last_updated": "2007-11-16",
        "status": "A",
        "authorized_official_last_name": "DALE",
        "authorized_official_first_name": "STEVEN",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "509-453-3103",
        "authorized_official_credential": "PT"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist",
            "state": "WA",
            "license": "PT00000697",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LABOR & INDUSTRIES",
            "identifier": "13762",
            "state": "WA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7037187",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Medical Associates of Yakima, LLC
• Medical Associates of Yakima, LLC
• Medical Associates of Yakima, LLC
• Medical Center
• Medical Center Laboratory, Inc. PS
• Medicine Mart 4TH Ave
• Medicine Mart Downtown
• Ayla Naomi Medina-Ulloa
• Jasmine Medrano
• Julie Sue Medrano, RN

• Physical Therapist in Yakima, WA
• Providers in Yakima, 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 16, 2007; 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.