NPIMap

Organization Active NPI

Javaman PS

Doing business as Pacific Northwest Rehab & Diagnostics

  • Speech-Language Pathologist
  • Bellingham, WA
National Provider Identifier
1730886466
Registry record updated Sep 5, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
Legal business name
JAVAMAN PS
Doing business as
Pacific Northwest Rehab & Diagnostics
Practice address
381 W Horton Rd
Bellingham, WA 98226-7740
Phone
(360) 733-4008
Fax
(360) 733-4064
NPI assigned
Feb 13, 2023
Last updated
Sep 5, 2023By the provider in NPPES
Organization subpart
Yes
Parent organization
JAVAMAN PSAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Sep 5, 2023

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

Authorized official

Name
Eric D Short-MillerNPI 1710959143
Title
Owner
Phone
(360) 733-4008

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X NU Primary

Addresses

Primary practice location

381 W Horton Rd
Bellingham, WA 98226-7740

Mailing address

2075 Barkley Blvd Ste 200
Bellingham, WA 98226-6696
Phone (360) 733-4008

Other names 1

  • Pacific Northwest Rehab & Diagnostics Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Performance Physical Therapy Inc2 organizations share this tax ID, including this one
Part of
Performance Physical Therapy Inc

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

  • Javaman PS

    dba Fyzical Therapy & Balance Centers

    • Physical Therapy Clinic/Center
    • Bellingham, WA
    • NPI 1841255502
    NPD tax ID

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

Practitioners & affiliated clinicians

Practitioners 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1676246400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1693872000000",
    "number": "1730886466",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2075 BARKLEY BLVD STE 200",
            "city": "BELLINGHAM",
            "state": "WA",
            "postal_code": "982266696",
            "telephone_number": "360-733-4008"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "381 W HORTON RD",
            "city": "BELLINGHAM",
            "state": "WA",
            "postal_code": "982267740",
            "telephone_number": "360-733-4008",
            "fax_number": "360-733-4064"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JAVAMAN PS",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "JAVAMAN PS",
        "enumeration_date": "2023-02-13",
        "last_updated": "2023-09-05",
        "certification_date": "2023-05-10",
        "status": "A",
        "authorized_official_last_name": "SHORT-MILLER",
        "authorized_official_first_name": "ERIC",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "360-733-4008"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Pacific Northwest Rehab & Diagnostics",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Bellingham, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 5, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.