NPIMap

Organization Active NPI

Daniel R. Coleman

Doing business as Tenino Physical Therapy

  • Physical Therapist
  • Tenino, WA
National Provider Identifier
1679752968
Registry record updated Dec 3, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT00002127 Issued in WA
Legal business name
DANIEL R. COLEMAN
Doing business as
Tenino Physical Therapy
Practice address
397 Sussex Ave E
Tenino, WA 98589-9272
Phone
(360) 264-6622
Fax
(360) 264-6624
NPI assigned
Nov 2, 2007
Last updated
Dec 3, 2010By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 3, 2010

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

Authorized official

Name
Daniel R Coleman, PTNPI 1275570574
Title
Owner
Phone
(360) 264-6622

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X PT00002127 WA Primary

Addresses

Primary practice location

397 Sussex Ave E
Tenino, WA 98589-9272

Mailing address

PO Box 255
Tenino, WA 98589-0255
Phone (360) 264-6622

Other identifiers 4

IdentifierTypeStateIssuer
CO5972OtherBLUE CROSS
121283OtherWAL&I
TE5934OtherWAREGENCE BLUE SHIELD
7091473MedicaidWA

Other names 1

  • Tenino Physical Therapy Doing business as

National Provider Directory

National Provider Directory

Locations

397 Sussex Ave E
Unit A
Tenino, WA 98589
Phone (360) 264-6622

Practitioners & affiliated clinicians

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.

NPI Registry JSON

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

{
    "created_epoch": "1193961600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1291334400000",
    "number": "1679752968",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 255",
            "city": "TENINO",
            "state": "WA",
            "postal_code": "985890255",
            "telephone_number": "360-264-6622"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "397 SUSSEX AVE E",
            "city": "TENINO",
            "state": "WA",
            "postal_code": "985899272",
            "telephone_number": "360-264-6622",
            "fax_number": "360-264-6624"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DANIEL R. COLEMAN",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-11-02",
        "last_updated": "2010-12-03",
        "status": "A",
        "authorized_official_last_name": "COLEMAN",
        "authorized_official_first_name": "DANIEL",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "360-264-6622",
        "authorized_official_credential": "PT"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "WA",
            "license": "PT00002127",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "CO5972",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "L&I",
            "identifier": "121283",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "REGENCE BLUE SHIELD",
            "identifier": "TE5934",
            "state": "WA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7091473",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Tenino Physical Therapy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Tenino, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 3, 2010; 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.