Individual provider Active NPI

Laura Mizumoto, DPT

  • Physical Therapist
  • Gig Harbor, WA
National Provider Identifier
1679984223
Registry record updated Jan 20, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
60226057 Issued in WA
Practice address
7306 Stinson Ave
Gig Harbor, WA 98335-1140
Phone
(253) 858-3332
Fax
(253) 858-3327
NPI assigned
May 16, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 20, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 60226057 WA Primary

Addresses

Primary practice location

7306 Stinson Ave
Gig Harbor, WA 98335-1140

Mailing address

7306 Stinson Ave
Gig Harbor, WA 98335-1140
Phone (425) 776-0803

Other practice location 1

4030 Alderwood Mall Blvd
Lynnwood, WA 98036
Phone (425) 776-0803

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20201020002459 WA Practitioner - Physical Therapist in Private Practice 5193145761 Reassigns benefits to 3 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
60226057WAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
King County Public Hospital District No. 2 Physical Therapist CurrentSince Sep 1, 2021 Accepting new patients
Hanson and Purdue Physical Therapy Inc PS Physical Therapist CurrentSince Jan 1, 2021 Accepting new patients
Washington Luna Care Physical Therapy LLC Physical Therapist CurrentSince Oct 16, 2020 Accepting new patients
King County Public Hospital District No 2 Current Accepting new patients

Locations

13555 SE 36th St
Ste 100
Bellevue, WA 98006

7306 Stinson Ave
Gig Harbor, WA 98335
Phone (253) 858-3332

12040 NE 128th St
#10
Kirkland, WA 98034
Phone (206) 466-0369

Organizations & group practices 4

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": "1400198400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1611100800000",
    "number": "1679984223",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7306 STINSON AVE",
            "city": "GIG HARBOR",
            "state": "WA",
            "postal_code": "983351140",
            "telephone_number": "425-776-0803",
            "fax_number": "425-776-0813"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7306 STINSON AVE",
            "city": "GIG HARBOR",
            "state": "WA",
            "postal_code": "983351140",
            "telephone_number": "253-858-3332",
            "fax_number": "253-858-3327"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4030 Alderwood Mall Blvd",
            "address_purpose": "LOCATION",
            "city": "Lynnwood",
            "state": "WA",
            "postal_code": "98036",
            "country_code": "US",
            "telephone_number": "425-776-0803",
            "fax_number": "425-776-0813",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MIZUMOTO",
        "first_name": "LAURA",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-05-16",
        "last_updated": "2021-01-20",
        "certification_date": "2021-01-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "WA",
            "license": "60226057",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gig Harbor, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 20, 2021; 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.