Active NPI
Trista Bryelle Berlien, LMP
- Physical Therapist
- Renton, WA
National Provider Identifier
1679882831
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- PT00009421
- Practice address
- 17650 140TH Ave SE
#B-07
Renton, WA 98058-6814 - Phone
- (425) 430-0700
- Fax
- (425) 430-0710
- NPI assigned
- Oct 5, 2010
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | PT00009421 | WA | Primary |
Addresses
Primary practice location
17650 140TH Ave SE
#B-07
Renton, WA 98058-6814
Mailing address
PO Box 2170
Sumner, WA 98390-0480
Phone (253) 840-2313
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PT00009421 | WA | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1286236800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1286236800000",
"number": "1679882831",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 2170",
"city": "SUMNER",
"state": "WA",
"postal_code": "983900480",
"telephone_number": "253-840-2313",
"fax_number": "253-840-6340"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "17650 140TH AVE SE",
"address_2": "#B-07",
"city": "RENTON",
"state": "WA",
"postal_code": "980586814",
"telephone_number": "425-430-0700",
"fax_number": "425-430-0710"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BERLIEN",
"first_name": "TRISTA",
"middle_name": "BRYELLE",
"credential": "LMP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2010-10-05",
"last_updated": "2010-10-05",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "WA",
"license": "PT00009421",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Renton, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 5, 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.