Active NPI
Stacy Hope Goldberg, MSPT
- Physical Therapist
- Seattle, WA
National Provider Identifier
1740395151
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- PT00009186
- Practice address
- 1959 NE Pacific St
Box 356490
Seattle, WA 98195-6490 - Phone
- (206) 598-4830
- NPI assigned
- Aug 19, 2006
- Sex
- Female
- 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 | PT00009186 | WA | Primary |
Addresses
Primary practice location
1959 NE Pacific St
Box 356490
Seattle, WA 98195-6490
Mailing address
805 Carlyon Ave SE
Olympia, WA 98501-3501
Phone (206) 788-7446
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PT00009186 | WA | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1155945600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1740395151",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "805 CARLYON AVE SE",
"city": "OLYMPIA",
"state": "WA",
"postal_code": "985013501",
"telephone_number": "206-788-7446"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1959 NE PACIFIC ST",
"address_2": "BOX 356490",
"city": "SEATTLE",
"state": "WA",
"postal_code": "981956490",
"telephone_number": "206-598-4830"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GOLDBERG",
"first_name": "STACY",
"middle_name": "HOPE",
"name_prefix": "Ms.",
"credential": "MSPT",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-08-19",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "WA",
"license": "PT00009186",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Seattle, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 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.