Soundview Physical Therapy, Inc.

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

PT 00002811 Issued in WA

Legal business name

SOUNDVIEW PHYSICAL THERAPY, INC.

Practice address

3711 Pacific Ave Ste 101
Tacoma, WA 98418-7800

Phone

(253) 475-4415

Fax

(253) 475-3034

NPI assigned

Dec 19, 2011

Organization subpart

No

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

Authorized official

Name

Darryl Mathew Kelleher, P.T.

Title

Owner/Physical Therapist

Phone

(253) 475-4415

Specialties & licenses 1

Addresses

Other identifiers 2

Locations

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

{
    "created_epoch": "1324252800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1324252800000",
    "number": "1780953836",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3711 PACIFIC AVE STE 101",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "984187800",
            "telephone_number": "253-475-4415",
            "fax_number": "253-475-3034"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3711 PACIFIC AVE STE 101",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "984187800",
            "telephone_number": "253-475-4415",
            "fax_number": "253-475-3034"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUNDVIEW PHYSICAL THERAPY, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-12-19",
        "last_updated": "2011-12-19",
        "status": "A",
        "authorized_official_last_name": "KELLEHER",
        "authorized_official_first_name": "DARRYL",
        "authorized_official_middle_name": "MATHEW",
        "authorized_official_title_or_position": "OWNER/PHYSICAL THERAPIST",
        "authorized_official_telephone_number": "253-475-4415",
        "authorized_official_credential": "P.T."
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist",
            "state": "WA",
            "license": "PT 00002811",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DEPT OF L & I",
            "identifier": "0032330",
            "state": "WA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7160054",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• South Puget Sound Neurology, PLLC

• Physical Therapist in Tacoma, WA
• Providers in Tacoma, WA by specialty
• Physical Therapist in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 19, 2011; 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.