Active NPI
Aerie Glowka
- Physical Therapist
- Lacey, WA
National Provider Identifier
1720505530
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 60745467
- Practice address
- 4219 6TH Ave SE Ste B
Lacey, WA 98503-1065 - Phone
- (360) 455-4448
- Fax
- (360) 455-9833
- NPI assigned
- Aug 23, 2017
- 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 | 60745467 | WA | Primary |
Addresses
Primary practice location
4219 6TH Ave SE Ste B
Lacey, WA 98503-1065
Mailing address
111 Tumwater Blvd SE Ste 113
Tumwater, WA 98501-6422
Phone (360) 528-3300
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 60745467 | WA | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1503446400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1503446400000",
"number": "1720505530",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "111 TUMWATER BLVD SE STE 113",
"city": "TUMWATER",
"state": "WA",
"postal_code": "985016422",
"telephone_number": "360-528-3300",
"fax_number": "360-528-8162"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4219 6TH AVE SE STE B",
"city": "LACEY",
"state": "WA",
"postal_code": "985031065",
"telephone_number": "360-455-4448",
"fax_number": "360-455-9833"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GLOWKA",
"first_name": "AERIE",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2017-08-23",
"last_updated": "2017-08-23",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "WA",
"license": "60745467",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Lacey, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 23, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.