Active NPI
George Palmer, P.T
- Physical Therapist
- Longview, WA
National Provider Identifier
1700837655
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- PT00002329
- Practice address
- 625 9TH Avenue
Suite 220
Longview, WA 98632-2544 - Phone
- (360) 578-1188
- Fax
- (360) 578-6251
- NPI assigned
- May 15, 2006
- Sex
- Male
- Sole proprietor
- Yes
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 | PT00002329 | WA | Primary |
Addresses
Primary practice location
625 9TH Avenue
Suite 220
Longview, WA 98632-2544
Mailing address
625 9TH Avenue
Suite 220
Longview, WA 98632
Phone (360) 578-1188
Other identifiers 4
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 205245 | Other | WA | DEPARTMENT OF LABOR AND I |
| 8940636 | Other | WA | CRIME VICTIMS |
| 205245 | Medicaid | WA | |
| 130909 | Other | WA | KAISER PERMANENTE |
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)
- Enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1147651200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1184198400000",
"number": "1700837655",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "625 9TH AVENUE",
"address_2": "SUITE 220",
"city": "LONGVIEW",
"state": "WA",
"postal_code": "98632",
"telephone_number": "360-578-1188",
"fax_number": "360-578-6251"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "625 9TH AVENUE",
"address_2": "SUITE 220",
"city": "LONGVIEW",
"state": "WA",
"postal_code": "986322544",
"telephone_number": "360-578-1188",
"fax_number": "360-578-6251"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PALMER",
"first_name": "GEORGE",
"name_prefix": "Mr.",
"credential": "P.T",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-05-15",
"last_updated": "2007-07-12",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "WA",
"license": "PT00002329",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "DEPARTMENT OF LABOR AND I",
"identifier": "205245",
"state": "WA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CRIME VICTIMS",
"identifier": "8940636",
"state": "WA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "205245",
"state": "WA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "KAISER PERMANENTE",
"identifier": "130909",
"state": "WA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Longview, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 12, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.