Active NPI
Ryan Donahoe, PHYSICAL THERAPIST
- Physical Therapist
- Lakewood, WA
National Provider Identifier
1730508680
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- PT60539764
- Practice address
- 5605 100TH St SW
Ste B
Lakewood, WA 98499-2710 - Phone
- (253) 284-9800
- Fax
- (360) 704-7676
- NPI assigned
- Apr 8, 2014
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Cardiopulmonary Physical Therapist | 2251C2600X | 036559-1 | NY | |
| Physical Therapist | 225100000X | PT60539764 | WA | Primary |
Addresses
Primary practice location
5605 100TH St SW
Ste B
Lakewood, WA 98499-2710
Mailing address
790 Remington Blvd
Bolingbrook, IL 60440-4909
Phone (630) 296-2223
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 |
|---|---|---|---|
| PT60539764 | WA | MD | Physical Therapist |
| 036559-1 | NY | MD | Cardiopulmonary Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1396915200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1428364800000",
"number": "1730508680",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "790 REMINGTON BLVD",
"city": "BOLINGBROOK",
"state": "IL",
"postal_code": "604404909",
"telephone_number": "630-296-2223",
"fax_number": "630-759-9510"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5605 100TH ST SW",
"address_2": "STE B",
"city": "LAKEWOOD",
"state": "WA",
"postal_code": "984992710",
"telephone_number": "253-284-9800",
"fax_number": "360-704-7676"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DONAHOE",
"first_name": "RYAN",
"name_prefix": "Mr.",
"credential": "PHYSICAL THERAPIST",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2014-04-08",
"last_updated": "2015-04-07",
"status": "A"
},
"taxonomies": [
{
"code": "2251C2600X",
"taxonomy_group": "",
"desc": "Physical Therapist, Cardiopulmonary",
"state": "NY",
"license": "036559-1",
"primary": false
},
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "WA",
"license": "PT60539764",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Lakewood, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 7, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.