NPIMap

Organization Active NPI

Proaction Physical Therapy, PLLC

  • Physical Therapist
  • Marysville, WA
National Provider Identifier
1689811770
Registry record updated Jan 12, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT00008156 Issued in WA
Legal business name
PROACTION PHYSICAL THERAPY, PLLC
Practice address
6618 64TH St NE
Suite D
Marysville, WA 98270-4883
Phone
(360) 653-5800
Fax
(360) 653-5880
NPI assigned
Jan 12, 2009
Last updated
Jan 12, 2009By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 12, 2009

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

Authorized official

Name
Lance Todd Aalbu, MPT, CSCSNPI 1003825043
Title
Managing Member
Phone
(425) 327-1784

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 PT00008156 WA Primary

Addresses

Primary practice location

6618 64TH St NE
Suite D
Marysville, WA 98270-4883

Mailing address

6618 64TH St NE
Suite D
Marysville, WA 98270-4883
Phone (360) 653-5800

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20090615000562 WA Part B Supplier - Clinic/Group Practice 8921158882 Receives reassigned benefits from 7 practitioners
Practice locations: Lake Stevens, WA; Marysville, WA

National Provider Directory

National Provider Directory

Locations

1109 Frontier Cir E
Ste B
Lake Stevens, WA 98258
Phone (425) 377-1290

6618 64th St NE
Ste D
Marysville, WA 98270
Phone (360) 653-5800

Practitioners & affiliated clinicians

Practitioners 15

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 15

NPI Registry JSON

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

{
    "created_epoch": "1231718400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1231718400000",
    "number": "1689811770",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6618 64TH ST NE",
            "address_2": "SUITE D",
            "city": "MARYSVILLE",
            "state": "WA",
            "postal_code": "982704883",
            "telephone_number": "360-653-5800",
            "fax_number": "360-653-5880"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6618 64TH ST NE",
            "address_2": "SUITE D",
            "city": "MARYSVILLE",
            "state": "WA",
            "postal_code": "982704883",
            "telephone_number": "360-653-5800",
            "fax_number": "360-653-5880"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROACTION PHYSICAL THERAPY, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-01-12",
        "last_updated": "2009-01-12",
        "status": "A",
        "authorized_official_last_name": "AALBU",
        "authorized_official_first_name": "LANCE",
        "authorized_official_middle_name": "TODD",
        "authorized_official_title_or_position": "MANAGING MEMBER",
        "authorized_official_telephone_number": "425-327-1784",
        "authorized_official_credential": "MPT, CSCS"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "WA",
            "license": "PT00008156",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Marysville, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 12, 2009; 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.