Individual provider Active NPI

Colin Moran, ATC

  • Physical Therapist
  • Marysville, WA
National Provider Identifier
1659837292
Registry record updated May 24, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
61442220 Issued in WA
Practice address
3719 88TH St NE Ste a
Marysville, WA 98270-7228
Phone
(360) 659-9621
NPI assigned
Feb 19, 2019
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 24, 2023

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Athletic Trainer 2255A2300X 2000050565
Nurse's Aide 376K00000X 353331 MT
Student in an Organized Health Care Education/Training Program 390200000X OR
Physical Therapist 225100000X 61442220 WA Primary

Addresses

Primary practice location

3719 88TH St NE Ste a
Marysville, WA 98270-7228

Mailing address

923 112TH St SW Apt D320
Everett, WA 98204-7870
Phone (406) 480-0477

Other practice location 1

923 112th St SW Apt D320
Everett, WA 98204-7870
Phone (406) 480-0477

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230714000413 WA Practitioner - Physical Therapist in Private Practice 3678933280 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Manual Therapy International Professional Services PLLCGroup PAC ID 7012808041, 44 clinicians

Practice addresses (Care Compare)

3200 W McGraw St
Seattle, WA 98199-3208
Phone (206) 281-7970

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
61442220WAMDPhysical Therapist
353331MTMDNurse's Aide

Practice roles

OrganizationSpecialtyStatusNew patients
Manual Therapy International Professional Services PLLC Physical Therapist CurrentSince Apr 19, 2024 Accepting new patients
Cascade Rehabilitation Associates, PLLC Physical Therapist CurrentSince Jun 12, 2023 Accepting new patients
Summit Rehabilitation PLLC CurrentSince Jun 12, 2023 Accepting new patients
Summit Rehabilitation PLLC Physical Therapist Current Accepting new patients
Summit Rehabilitation PLLC Physical Therapist CurrentSince Jun 12, 2023 Accepting new patients
Cascade Rehabilitation Associates, PLLC Physical Therapist CurrentSince Jun 12, 2023 Accepting new patients

Locations

3710 168th St NE
Ste A102
Arlington, WA 98223
Phone (360) 226-5151

1560 140th Ave NE
Ste 100
Bellevue, WA 98005
Phone (425) 746-2475

10511 19th Ave SE
Ste B
Everett, WA 98208
Phone (425) 357-8885

9514 4th St NE
Unit 101
Lake Stevens, WA 98258
Phone (425) 397-2327

3719 88th St NE
Ste A
Marysville, WA 98270
Phone (360) 659-9621

3200 W McGraw St
Seattle, WA 98199
Phone (206) 281-7970

Organizations & group practices 6

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1550534400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1684886400000",
    "number": "1659837292",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "923 112TH ST SW APT D320",
            "city": "EVERETT",
            "state": "WA",
            "postal_code": "982047870",
            "telephone_number": "406-480-0477"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3719 88TH ST NE STE A",
            "city": "MARYSVILLE",
            "state": "WA",
            "postal_code": "982707228",
            "telephone_number": "360-659-9621"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "923 112th St SW Apt D320",
            "address_purpose": "LOCATION",
            "city": "Everett",
            "state": "WA",
            "postal_code": "982047870",
            "country_code": "US",
            "telephone_number": "406-480-0477",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MORAN",
        "first_name": "COLIN",
        "credential": "ATC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-02-19",
        "last_updated": "2023-05-24",
        "certification_date": "2023-05-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": null,
            "license": "2000050565",
            "primary": false
        },
        {
            "code": "376K00000X",
            "taxonomy_group": "",
            "desc": "Nurse's Aide",
            "state": "MT",
            "license": "353331",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "OR",
            "license": null,
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "WA",
            "license": "61442220",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Marysville, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 24, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.