Individual provider Active NPI

Priscilla Anne Coyner, MPT PCS

  • Physical Therapist
  • Issaquah, WA
National Provider Identifier
1770627952
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT00002750 Issued in WA
Practice address
710 NW Juniper St
Suite104
Issaquah, WA 98027-2717
Phone
(425) 392-7989
Fax
(425) 391-2554
NPI assigned
Feb 19, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X PT00002750 WA Primary

Addresses

Primary practice location

710 NW Juniper St
Suite104
Issaquah, WA 98027-2717

Mailing address

14917 256TH Ave SE
Issaquah, WA 98027-8333
Phone (425) 392-7989

Other identifiers 2

IdentifierTypeStateIssuer
CO2118OtherWAREGENCE
7038037MedicaidWA

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

LicenseStateTypeSpecialty
PT00002750WAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
RWW Pediatric Rehab Services LLC Physical Therapist Past Accepting new patients
Northwest Pediatric Therapies, PS Physical Therapist Past Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1171843200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1770627952",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14917 256TH AVE SE",
            "city": "ISSAQUAH",
            "state": "WA",
            "postal_code": "980278333",
            "telephone_number": "425-392-7989",
            "fax_number": "425-391-2554"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "710 NW JUNIPER ST",
            "address_2": "SUITE104",
            "city": "ISSAQUAH",
            "state": "WA",
            "postal_code": "980272717",
            "telephone_number": "425-392-7989",
            "fax_number": "425-391-2554"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COYNER",
        "first_name": "PRISCILLA",
        "middle_name": "ANNE",
        "name_prefix": "Mrs.",
        "credential": "MPT PCS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-19",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "WA",
            "license": "PT00002750",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "REGENCE",
            "identifier": "CO2118",
            "state": "WA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7038037",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Issaquah, 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.

Verify at the official NPI Registry.