Melissa Racouillat, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

PT60383867 Issued in WA

Practice address

14028 SE Petrovitsky Rd
Renton, WA 98058-8933

Phone

(425) 272-0252

NPI assigned

Nov 26, 2007

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Therapeutic Associates Inc

  • Physical Therapist
  • Renton, WA
  • NPI 1629054465
  NPD (past)
• Lisa M Giannone Et Al PTR

  • Physical Therapist
  • San Francisco, CA
  • NPI 1750497913
  NPD (past)
• Sports & Orthopedic Leaders Physical Therapy, Inc

  • Physical Therapist
  • Oakland, CA
  • NPI 1013981760
  NPD (past)

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

{
    "created_epoch": "1196035200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1411948800000",
    "number": "1679754170",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 9955",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981090955",
            "telephone_number": "415-680-0247"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14028 SE PETROVITSKY RD",
            "city": "RENTON",
            "state": "WA",
            "postal_code": "980588933",
            "telephone_number": "425-272-0252"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RACOUILLAT",
        "first_name": "MELISSA",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-11-26",
        "last_updated": "2014-09-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "PT 34048",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "WA",
            "license": "PT60383867",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1679754170",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WA L&I",
            "identifier": "328947",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WA L&I",
            "identifier": "328948",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Marco Ryan Quintero, SUDPT
• Cynamon Quinton, RD, CD
• Andrew Ramon Quisumbing, DO
• Heather Qunell
• Gayleen C Racey, PTA
• Elena Radea
• Raymond J Radell, RN
• Meghana Raghavan, MD
• Erin C Rahn, LMP
• Rain Field Counseling & Consulting Inc.

• Physical Therapist in Renton, WA
• Providers in Renton, WA by specialty
• Physical Therapist in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 29, 2014; 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.