NPIMap

Organization Active NPI

Flex Physical Therapy

  • Physical Therapist
  • Bothell, WA
National Provider Identifier
1679574479
Registry record updated Jul 8, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
602 198893 Issued in WA
Legal business name
FLEX PHYSICAL THERAPY
Practice address
12900 NE 180TH St
#110
Bothell, WA 98011-5773
Phone
(425) 483-4270
Fax
(425) 483-4268
NPI assigned
Aug 3, 2005
Last updated
Jul 8, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2025

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

Authorized official

Name
Diane Thusat, P. TNPI 1306056478
Title
President/Physical Therapist
Phone
(425) 483-4270

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 602 198893 WA Primary

Addresses

Primary practice location

12900 NE 180TH St
#110
Bothell, WA 98011-5773

Mailing address

12900 NE 180TH St
#110
Bothell, WA 98011-5773
Phone (425) 483-4270

Other identifiers 1

IdentifierTypeStateIssuer
7116486MedicaidWA

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040330001764 WA Part B Supplier - Clinic/Group Practice 9537151600 Receives reassigned benefits from 11 practitioners
Practice locations: Bothell, WA

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 17

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.

View all 17

NPI Registry JSON

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

{
    "created_epoch": "1123027200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1751932800000",
    "number": "1679574479",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12900 NE 180TH ST",
            "address_2": "#110",
            "city": "BOTHELL",
            "state": "WA",
            "postal_code": "980115773",
            "telephone_number": "425-483-4270",
            "fax_number": "425-483-4268"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12900 NE 180TH ST",
            "address_2": "#110",
            "city": "BOTHELL",
            "state": "WA",
            "postal_code": "980115773",
            "telephone_number": "425-483-4270",
            "fax_number": "425-483-4268"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FLEX PHYSICAL THERAPY",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-08-03",
        "last_updated": "2025-07-08",
        "certification_date": "2025-07-08",
        "status": "A",
        "authorized_official_last_name": "THUSAT",
        "authorized_official_first_name": "DIANE",
        "authorized_official_title_or_position": "PRESIDENT/PHYSICAL THERAPIST",
        "authorized_official_telephone_number": "425-483-4270",
        "authorized_official_credential": "P. T"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "WA",
            "license": "602 198893",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7116486",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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 Jul 8, 2025; 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.